Maternal and Neonatal Outcome in Pregnant Women with Chronic Energy Deficiency in Cipto Mangunkusumo General Hospital, Indonesia

Junita Indarti; Henny Sugiharto Wonodihardjo; Kristian Alda Sianipar; Mohammad Agassi Antoniman

doi:10.3889/oamjms.2023.8509

Authors

Junita Indarti Department of Obstetric and Gynecology, Faculty of Medicine University of Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-2565-2852
Henny Sugiharto Wonodihardjo Department of Obstetric and Gynecology, Faculty of Medicine University of Indonesia, Jakarta, Indonesia
Kristian Alda Sianipar Department of Obstetric and Gynecology, Faculty of Medicine University of Indonesia, Jakarta, Indonesia
Mohammad Agassi Antoniman Faculty of Medicine University of Indonesia, Jakarta, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2023.8509

Keywords:

Maternal malnutrition, Chronic energy deficiency, Maternal outcome, Neonatal outcomes

Abstract

Introduction : Malnutrition in pregnant women disrupts the First Thousand Days of Life (DOL). DOL is known as the Window of Opportunity or the Golden Period, which occurs for 1000 DOL to improve children's growth and development optimally. Disturbances that arise during this period will impact the survival of the child and child’s growth and development, which is permanent. However, malnutrition in pregnant women can be prevented by early intervention. Therefore, this study aims to describe the maternal and neonatal outcomes in pregnant women with chronic energy deficiency malnutrition.

Method: This research is a retrospective cohort study with a descriptive research design. Eighty-one pregnant women with malnutrition who came to Cipto Mangunkusumo Hospital from 2017 to 2020 were included. Subject characteristic, maternal and neonatal outcome were collected from the medical record.

Result : Some of our subjects had moderate (26%) and severe (16%) malnutrition before pregnancy. The average weight gain is 8.78 kg, lower than the recommendation. The results of this study showed a high incidence of anemia (51,9%) and perinatal maternal complications (54,4%). The neonatal outcome showed a high incidence of congenital defects and hyaline membrane disease (p = 0.031) and NICU care (p = 0.001). The incidence of hyaline membrane disease and congenital defects is 15(18,5%) and 5(6.1%) in this study.

Conclusion : Chronic energy deficiency in pregnancy could lead to significant maternal and neonatal complications.

Keywords: Maternal malnutrition, chronic energy deficiency, maternal outcome, neonatal outcomes.

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References

WHO. What is Malnutrition? World Health Organization. Available from: http://www.who.int/features/qa/malnutrition/en/. [Last accessed on 2020 Sept 08].

Desyibelew HD, Dadi AF. Burden and determinants of malnutrition among pregnant women in Africa: A systematic review and meta-analysis. PLoS One. 2019;14(9):e0221712. https://doi.org/10.1371/journal.pone.0221712 PMid:31490956 DOI: https://doi.org/10.1371/journal.pone.0221712

Organization WH. The Extension of 2025 Maternal, Infant, and Young Child Nutrition Target to 2030. United Nations Children’s Fund (UNICEF): USA; 2019.

Urooj A, Rao KA, Sesikeran B, editors. Maternal Malnutrition in Low-Income and Middle-Income Countries: A Closer Look at the Indian Scenario.EC Paediatrics. 2018;7:295-311. DOI: https://doi.org/10.52439/FJFX3922

Indonesia BPdPKR. Riset Kesehatan Dasar 2018: Kementrian Kesehatan Republik Indonesia; 2018. Available from: https://www.depkes.go.id/resources/download/info-terkini/hasil-riskesdas-2018.pdf [Last accessed on 2021 Nov 07].

UNICEF. Across South Asia, Women Lack the Nutritional Care they Urgently Need; 2018. Available from: https://www.unicef.org/rosa/press-releases/across-south-asia-women-lack-nutritional-care-they-urgently-need [Last accessed on 2021 Oct 20].

Organization WH. The Double Burden of Malnutrition: Policy Brief; 2016. Available from: https://apps.who.int/iris/handle/10665/255413 [Last accessed on 2021 Sep 09].

Hanson MA, Bardsley A, De-Regil LM, Moore SE, Oken E, Poston L, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: “Think Nutrition First”. Int J Gynaecol Obstet. 2015;131 Suppl 4:S213-53. https://doi.org/10.1016/S0020-7292(15)30034-5 PMid:26433230 DOI: https://doi.org/10.1016/S0020-7292(15)30034-5

Cates JE, Unger HW, Briand V, Fievet N, Valea I, Tinto H, et al. Malaria, malnutrition, and birthweight: A meta-analysis using individual participant data. PLoS Med. 2017;14(8):e1002373. https://doi.org/10.1371/journal.pmed.1002373 PMid:28792500 DOI: https://doi.org/10.1371/journal.pmed.1002373

Abu-Saad K, Fraser D. Maternal nutrition and birth outcomes. Epidemiol Rev. 2010;32:5-25. https://doi.org/10.1093/epirev/mxq001 PMid:20237078 DOI: https://doi.org/10.1093/epirev/mxq001

Liu L, Hong Z, Zhang L. Associations of prepregnancy body mass index and gestational weight gain with pregnancy outcomes in nulliparous women delivering single live babies. Sci Rep. 2015;5:12863. https://doi.org/10.1038/srep12863 PMid:26242798 DOI: https://doi.org/10.1038/srep12863

Quinn JA, Munoz FM, Gonik B, Frau L, Cutland C, Mallett-Moore T, et al. Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine. 2016;34(49):6047-56. https://doi.org/10.1016/j.vaccine.2016.03.045 PMid:27743648 DOI: https://doi.org/10.1016/j.vaccine.2016.03.045

Serbesa ML, Iffa MT, Geleto M. Factors associated with malnutrition among pregnant women and lactating mothers in miesso health center, Ethiopia. Eur J Midwifery. 2019;3:13. https://doi.org/10.18332/ejm/110131 PMid:33537592 DOI: https://doi.org/10.18332/ejm/110131

Wubie A, Seid O, Eshetie S, Dagne S, Menber Y, Wasihun Y, et al. Determinants of chronic energy deficiency among non-pregnant and non-lactating women of reproductive age in rural Kebeles of Dera District, North West Ethiopia, 2019: Unmatched case control study. PLoS One. 2020;15(10):e0241341. https://doi.org/10.1371/journal.pone.0241341 PMid:33119701 DOI: https://doi.org/10.1371/journal.pone.0241341

Moediarso B, Budiono P, Fatihuddin M, En T, Rantam B, Gunawan A, et al. Differentiate factors of pregnant women with chronic energy deficiency occurrence in bajulmati village, wongsorejo district, banyuwangi regency 2019. J Community Med Public Health Res. 2020;1:24. DOI: https://doi.org/10.20473/jcmphr.v1i1.20297

Tette E, Sifah E, Nartey E, Nuro-Ameyaw P, Tete-Donkor P, Biritwum R. Maternal profiles and social determinants of malnutrition and the MDGs: What have we learnt? BMC Public Health. 2016;16:214. https://doi.org/10.1186/s12889-016-2853-z PMid:26935849 DOI: https://doi.org/10.1186/s12889-016-2853-z

Kumera G, Gedle D, Alebel A, Feyera F, Eshetie S. Undernutrition and its association with socio-demographic, anemia and intestinal parasitic infection among pregnant women attending antenatal care at the University of Gondar Hospital, Northwest Ethiopia. Matern Health Neonatol Perinatol. 2018;4:18. https://doi.org/10.1186/s40748-018-0087-z PMid:30214818 DOI: https://doi.org/10.1186/s40748-018-0087-z

Edowai N, Rantetampangc A, Msen Y, Mallongi A. Factors influencing with malnutrition pregnant at tigi district deiyai regency. Int J Sci Healthc Res. 2018;(4):12.

Nigatu M, Gebrehiwot T, Gemeda D. Household food insecurity, low dietary diversity, and early marriage were predictors for undernutrition among pregnant women residing in gambella, Ethiopia. Adv Public Health. 2018;2018:1-10. https://doi.org/10.1155/2018/1350195 DOI: https://doi.org/10.1155/2018/1350195

Getaneh T, Negesse A, Dessie G, Desta M, Assemie MA, Tigabu A. Predictors of malnutrition among pregnant women in Ethiopia: A systematic review and meta-analysis. Hum Nutrition Metab. 2021;26:200131. https://doi.org/10.1016/j.hnm.2021.200131 DOI: https://doi.org/10.1016/j.hnm.2021.200131

Adinma JI, Umeononihu O, Umeh MN. Maternal nutrition in Nigeria. Trop J Obstet Gynaecol. 2017;34:79. https://doi.org/10.4103/TJOG.TJOG_25_17 DOI: https://doi.org/10.4103/TJOG.TJOG_25_17

Suzuki K, Nomura K, Takenoshita S, Ando K, Kido M. Combination of parity and pre-pregnancy BMI and low birth weight infants among Japanese women of reproductive age. Ind Health. 2016;54(6):515-20. https://doi.org/10.2486/indhealth.2016-0088 PMid:27476380 DOI: https://doi.org/10.2486/indhealth.2016-0088

Zelalem A, Endeshaw M, Awoke M, Shiferaw S, Yirgu R. Effect of nutrition education on pregnancy specific nutrition knowledge and healthy dietary practice among pregnant women in addis ababa. Clin Mother Child Health. 2017;14:1000265. https://doi.org/10.4172/2090-7214.1000265 DOI: https://doi.org/10.4172/2090-7214.1000265

Helliyana H, Aritonang E, Sanusi S. The associations between maternal education, chronic energy deficit, and anemia in pregnant women: An evidence from Lhokseumawe, Indonesia. J Matern Child Health. 2019;4:302-6. https://doi.org/10.26911/thejmch.2019.04.05.02 DOI: https://doi.org/10.26911/thejmch.2019.04.05.02

Black R, Victora C, Walker S, Bhutta Z, Christian P, Onis M, et al. Maternal and Child Undernutrition and Overweight in Low- Income and Middle-Income Countries. Lancet. 2013;382:427-51. https://doi.org/10.1016/S0140-6736(13)60937-X PMid:23746772 DOI: https://doi.org/10.1016/S0140-6736(13)60937-X

Stephen G, Mgongo M, Hashim T, Katanga J, Stray-Pedersen B, Msuya S. Anaemia in pregnancy: Prevalence, risk factors, and adverse perinatal outcomes in Northern Tanzania. Anemia. 2018;2018:1-9. https://doi.org/10.1155/2018/1846280 PMid:29854446 DOI: https://doi.org/10.1155/2018/1846280

Patel A, Prakash AA, Das PK, Gupta S, Pusdekar YV, Hibberd PL. Maternal anemia and underweight as determinants of pregnancy outcomes: Cohort study in eastern rural Maharashtra, India. BMJ Open. 2018;8(8):e021623. https://doi.org/10.1136/bmjopen-2018-021623 PMid:30093518 DOI: https://doi.org/10.1136/bmjopen-2018-021623

de Onis M, Blössner M, Borghi E. Prevalence and trends of stunting among pre-school children, 1990-2020. Public Health Nutr. 2012;15(1):142-8. https://doi.org/10.1017/ S1368980011001315 PMid:21752311 DOI: https://doi.org/10.1017/S1368980011001315

Han Z, Lutsiv O, Mulla S, Rosen A, Beyene J, McDonald SD. Low gestational weight gain and the risk of preterm birth and low birthweight: A systematic review and meta-analyses. Acta Obstet Gynecol Scand. 2011;90(9):935-54. https://doi.org/10.1111/j.1600-0412.2011.01185.x PMid:21623738 DOI: https://doi.org/10.1111/j.1600-0412.2011.01185.x

Yayla Abide C, Bostancı E, Kilicci C. Association between gestational weight gain and maternal and neonatal outcomes. East J Med. 2018;23:115-20. https://doi.org/10.5505/ejm.2018.49389 DOI: https://doi.org/10.5505/ejm.2018.49389

Gul R, Iqbal S, Anwar Z, Ahdi SG, Ali SH, Pirzada S. Pre-pregnancy maternal BMI as predictor of neonatal birth weight. PLoS One. 2020;15(10):e0240748. https://doi.org/10.1371/journal.pone.0240748 PMid:33112877 DOI: https://doi.org/10.1371/journal.pone.0240748

Clapp MA, James KE, Bates SV, Kaimal AJ. Unexpected term NICU admissions: A marker of obstetrical care quality? Am J Obstet Gynecol. 2019;220(4):395.e1-.e12. https://doi.org/10.1016/j.ajog.2019.02.001 PMid:30786256 DOI: https://doi.org/10.1016/j.ajog.2019.02.001

Sri R, Sumiaty S, Irmawati I, Sundari S. Relationship of chronic energy deficiency in pregnant women with low birth weight newborn in central sulawesi province. Int J Sci Basic Appl Res (IJSBAR). 2017;36(2):252-9.

Low Birth Weight – Health Encyclopedia – University of Rochester Medical Center. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=p02382 [Last accessed on 2021 Dec 02].

Salam R, Das J, Ali A, Lassi Z, Bhutta Z. Maternal undernutrition and intrauterine growth restriction. Expert Review of Obstetrics & Gynecology. 2014;8:559-67. https://doi.org/10.1586/17474108.2013.850857 DOI: https://doi.org/10.1586/17474108.2013.850857

Sharma N CS. Recurrent Pelvic Organ Prolapse. In: RM R, editor. Pelvic Floor Disorders. InTech; 2018. Available from: http://doi.org/10.5772/intechopen.76669 DOI: https://doi.org/10.5772/intechopen.76669

Rynn L, Cragan J, Correa A. Update on Overall Prevalence of Major Birth Defects – Atlanta, Georgia, 1978--2005: Center for Disease Control and Prevention. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a2.htm [Last accessed 2021 Nov 21].

Wu G, Imhoff-Kunsch B, Girard AW. Biological mechanisms for nutritional regulation of maternal health and fetal development. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:4-26. https://doi.org/10.1111/j.1365-3016.2012.01291.x PMid:22742599 DOI: https://doi.org/10.1111/j.1365-3016.2012.01291.x

Gernand A, Schulze K, Stewart C, West JK, Christian P. Micronutrient deficiencies in pregnancy worldwide: Health effects and prevention. Nat Rev Endocrinol. 2016;12:274-89. https://doi.org/10.1038/nrendo.2016.37 PMid:27032981 DOI: https://doi.org/10.1038/nrendo.2016.37

Policy Research Note No.5: The Economic Costs of Stunting and How to Reduce Them: World Bank. Available from: https://www.worldbank.org/en/research/brief/policy-research-note-no5-the-economic-costs-of-stunting-and-how-to-reduce-them [Last accessed on 2021 Nov 07].