Association of Birth Weight, Immunization, and Parity with

Nutritional Status of Children Under Five Years

Ony Linda

and Nurul Huriah Astuti

Study programme of public health, Faculty of health sciences, Universitas Muhammadiyah Prof. Dr. HAMKA, South

Jakarta, Indonesia

Keywords: Immunization status, Low birth weight, Nutritional status, Parity

Abstract: Children under five are one group at risk of health. This study aimed to assess variables associated with the

nutritional status of children under five. This cohort retrospective study of 216 children under five and their

mothers/ caregivers were conducted (January 2018) using cluster random sampling technique. This study

involved collecting information on the socio-demographic characteristic and anthropometric measurement

(Weight for height z-score) of the eligible children. About 51.9% were male, 32.9% mother/ caregivers were

illiterate. The result showed that about 70.1% were found to have normal nutritional status, 10.3% were

found to be moderately wasted, and 7.5% were found to be severely wasted. About 8.3% had low birth

weight, 11.6% were partially immunized, and 9.3% had high parity (≥ 5 children). There was a significant

statistical association of children having low birth weight, immunization status, and parity with nutritional

status among the children studied. There is a need to promote and encourage girl/ female health education in

the communities in order to build their awareness about maternal health and immunization.

1 INTRODUCTION

Children under five are one of the vulnerable

groups to health risk. Optimal nutritional status can

help them avoid disease problems. The impact of

malnutrition status includes reducing the quality of

human resources, increasing the risk of disease,

death and lack of intelligence of children, the risk of

death of children suffering from malnutrition, as

well as increasing malnutrition to 2.5 and 8 times

that of normal children. That influence nutritional

status are direct factors (food intake and infectious

diseases) and indirect (demographics, birth weight,

immunization, parity, etc.) Sukmawati dan Ayu

(2010). This study analyzed nutritional status based

on variables of birth weight, immunization, and

parity.

2 SUBJECTS AND METHODS

The research employed quantitative analytic with

a retrospective cohort design. The population

selected was all aged 10--59 months; they were the

visitors of posyandu. Samples were determined

using cluster random sampling (cluster = integrated

service post/ posyandu). The research location was

in the district Cipayung, Depok City (West Java),

particularly Cipayung (Posyandu RW 1, 9 and 11)

and Bojong Pondok Terong (Posyandu RW 2, 5, and

7). The sample size was calculated using the simple

random sampling formula (n = 98) with a design

effect of 2 (WHO provisions) and an additional

sampling error of 20% so that the total respondents

were 235, but only 216 respondents’ result can be

analyzed. The study was conducted in December

2017 until May 2018. Nutritional status data was

collected by measuring the weight for height index

Linda, O. and Astuti, N.

Association of Birth Weight, Immunization, and Parity with Nutritional Status of Children Under Five Years.

DOI: 10.5220/0008371000240027

In Proceedings of the 1st International Conference on Social Determinants of Health (ICSDH 2018), pages 24-27

ISBN: 978-989-758-362-9

(WFH). The results of calculations with WHO-

Anthro software were compared to the WHO NCHS

standard; other data (demography, birth weight

immunization, and parity) were by observation and

interview. Before conducting the data collection, this

study was approved by the UHAMKA Health

Ethical Research Committee.

3 RESULTS

Based on the analysis, the mother giving

exclusive breastfeeding have not met the WHO

standards (4.8 months) as shown in the following

table 1.

Table 1: Statistical value of the independet variabel.

No Variable Mean SD Min Max

Birth weight (kg) 3.04 0.45 1.4 4.5

Exclusive BF

(mo)

4.8 2.4 0 12

Start MP-ASI

(mo)

4.8 2.4 0 12

Mother age

(year)

30.7 6.9 17 47

Parity (child) 2 1.04 1 8

Income (Rp) 3286800 1788455 600000 15000000

Family Size

(people)

4.4 1.5 1 11

By using nutritional status measurements based

on weight for age (WFA), the results obtained

revealed that about 77% of respondents have good

nutritional status.

good

(

77.3%

)

poor

(22.7%)

Figure 1: Nutritional status of children under five years

based on WFA.

Demographic, immunization, weight, and

parity variables can be seen in the following

table

(table 2).

Table 2: Distribution of demographic, immunization,

weight and parity variables.

Variable n %

Preterm

1. Yes 27 12.5

2. No 189 87.5

Birth Weight

1. Low 18 8.3

2. Normal 198 91.7

Immunization Status

1. Incomplete 25 11.6

2. Complete 191 88.4

Infection Diseases

1. Yes 91 42.1

2. No 125 57.9

Sex

1. Male 112 51.9

2. Female 104 48.1

Born Status

1. Twins 2 0.9

2. Single 214 99.1

Exclusive

Breastfeeding

1. No 91 42.1

2. Yes 125 57.9

Bivariate analysis resulted in the following table

(Table 3).

Table 3: Bivariate analysis of independent variabel.

Variable

Nutritional Status

Total

P-

value

OR ((5%

CI)

Other Normal

Birth Weight

1. Yes (< 2.5

kg)

(55.6%)

(44.4%)

0.001

5.096

(1.887 –

13.763)

2. No (≥ 2.5

kg)

(19.7%)

159

(80.3%)

198

Immunization

Status

1. Incomplete

(48.0%)

(52.0%)

0.003

3.842

(1.621 –

9.105)

2. Complete

(19.4%)

154

(80.6%)

191

Parity

1. Risky (≥4

children)

(45%)

(55%)

0.026

3.191

(1.238 –

8.226)

2. No Risky

(<4 children)

(20.4%)

156

(79.6%)

196

Association of Birth Weight, Immunization, and Parity with Nutritional Status of Children Under Five Years

4 DISCUSSION

The nutritional status of respondents was not

good (about 22.7%). It was caused by less optimal

food intake. Food intake is influenced by purchasing

ability, which is also influenced by parents' income.

More than half (54.6%) of the respondents’ parents

have inadequate income. In addition, almost half of

them suffered from infectious diseases (42.1%). In

line with the results of research by Linda and Hamal

(2011) in Tangerang, Banten, it was found that

30.1% of children under five had poor nutrition.

Likewise, Linda’s (2012) study on children under

five in Bogor regency shows 19.9% of the

respondents were in poor nutrition.

Children in this research were born with low

birth weight/ LBW (8.3%). The cause of LBW,

among others, was mother having an upper arm

circumference (LILA) of less than 23.5 cm before

pregnancy, thereby exposing her to the risk of

chronic lack of energy. The condition leads mother

to be at risk of giving birth to LBW. LBW status is

related to the nutritional status with a value of OR

5,096. It means that babies born with LBW

conditions have a risk of 5,096 times greater to get

poor nutritional status than those born with normal

weight.

Linda’s (2013) study found that there were still

4.3% of babies born with LBW conditions. The

results of Riskesdas in 2007, 2010, and 2013,

claimed that LBW in Indonesia amounted to 8.3%,

11.1%, and 10.2%, respectively. In other words, the

prevalence of LBW in the study area was still

relatively lower than the national figure, but higher

than the Linda study (2013).

Incomplete immunization status (11.6%) could

happen because parents were reluctant to bring their

children to health facilities to be immunized on the

grounds that after the immunization they become

feverish, fussy, and even sick. Statistically, there is a

correlation between the completeness of

immunization and the nutritional status of children.

The OR showed a value of 3,842. It means that

respondents who have incomplete immunization had

a risk of 3,842 times greater to experience poor

nutritional status than those with the complete one.

In addition, working mothers are likely to be the

cause of their children not being immunized.

However, this figure is still lower compared to the

results of the 2013 Riskesdas, where children who

did not have complete immunization were 40.8%.

The parity was more than 4 people (9.3%). There

were mothers who did not support family planning

(KB) programs. The results of the Linda’s (2013)

study found that 6.4% of mothers had high parity.

However, the result does not show any relation with

nutritional status.

5. CONCLUSION

Although the nutritional status of children

under five is better, about half of them still

experience LBW, incomplete immunization, and

high parity.

ACKNOWLEDMENTS

Thanks to Financial supporter, University

Muhammadiyah of prof. DR HAMKA (UHAMKA)

through the Research and Development Institute.

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Association of Birth Weight, Immunization, and Parity with Nutritional Status of Children Under Five Years