The Relationship between the Level of Adherence to Antenatal Care and the Incidence of Chronic Energy Deficiency among Pregnant Women in Areas with a High Prevalence of Intellectual Disabilities
DOI:
https://doi.org/10.59141/-.v8i1.529Keywords:
antenatal care, ANC adherence, chronic energy deficiencyAbstract
Chronic energy deficiency among pregnant women remains an important maternal nutrition problem because it may increase the risk of adverse pregnancy outcomes and reflects inadequate nutritional status during pregnancy. Antenatal care adherence is expected to support early detection and prevention of nutritional disorders through routine maternal assessment, nutritional counseling, and anthropometric monitoring. This study aimed to analyze the relationship between antenatal care adherence and the incidence of chronic energy deficiency among pregnant women in Karangpatihan Village, Balong District, Ponorogo Regency, an area known for a high prevalence of intellectual disability. This study used an analytic observational design with a cross-sectional approach. The study population consisted of pregnant women who met the inclusion criteria and had complete data on antenatal care visits and mid-upper arm circumference measurement. Antenatal care adherence was categorized as adherent when respondents completed at least six visits and non-adherent when fewer than six visits were recorded. Chronic energy deficiency was defined as mid-upper arm circumference below 23.5 cm. Data were analyzed using the Chi-Square test. Among 70 respondents, 42 respondents (60%) were non-adherent to antenatal care and 39 respondents (55.7%) experienced chronic energy deficiency. Bivariate analysis showed a significant relationship between antenatal care adherence and chronic energy deficiency (p = 0.001; OR = 0.189; 95% CI: 0.067–0.535). These findings indicate that antenatal care adherence may have a protective role against chronic energy deficiency among pregnant women.
Downloads
References
Arsenault, C., Mfeka-Nkabinde, N. G., Chaudhry, M., Jarhyan, P., Taddele, T., Mugenya, I., Sabwa, S., Wright, K., Amboko, B., & Baensch, L. (2024). Antenatal care quality and detection of risk among pregnant women: An observational study in Ethiopia, India, Kenya, and South Africa. PLoS Medicine, 21(8), e1004446.
Bosáková, L. (2021). Breaking the cycle of poverty: routes to counteract intergenerational transmission of socioeconomic health differences.
de Juras, A. R., & Hu, S. C. (2023). A review on dietary patterns and double burden of malnutrition: knowledge gaps for future research. Asia Pacific Journal of Public Health, 35(1), 7–13.
Dégano, I. R., Marrugat, J., Grau, M., Salvador-González, B., Ramos, R., Zamora, A., Martí, R., & Elosua, R. (2017). The association between education and cardiovascular disease incidence is mediated by hypertension, diabetes, and body mass index. Scientific Reports, 7(1), 12370.
Demissie, M., Derribow, A. B., Jima, G. B., Workineh, B., Assime, A., Mulat, A., & Abera, M. (2026). Undernutrition and Associated Factors Among Pregnant Women Attending Antenatal Care: As a Strategy for Reducing Perinatal Morbidity. Nutrition and Metabolic Insights, 19. https://doi.org/10.1177/11786388261440211;SUBPAGE:STRING:FULL
Ecclestone, K. (2017). Changing the subject of education? A critical evaluation of ‘vulnerability creep’and its implications. Social Policy and Society, 16(3), 443–456.
Figa, Z., Temesgen, T., Mahamed, A. A., & Bekele, E. (2024). The effect of maternal undernutrition on adverse obstetric outcomes among women who attend antenatal care in Gedeo zone public hospitals, cohort study design. BMC Nutrition 2024 10:1, 10(1), 64-. https://doi.org/10.1186/S40795-024-00870-W
Getacher, L., Ademe, B. W., & Belachew, T. (2023). Understanding the national evidence on the double burden of malnutrition in Ethiopia for the implications of research gap identifications: a scoping review. BMJ Open, 13(12), e075600.
Herring, C. M., Bazer, F. W., Johnson, G. A., & Wu, G. (2018). Impacts of maternal dietary protein intake on fetal survival, growth, and development. Experimental Biology and Medicine, 243(6), 525–533.
Irma, Rahman, S. N., Ryska, H., & Hadju, V. (2025). Determinants of chronic energy deficiency (CED) in pregnant women in stunting. Jurnal Ilmiah Kesehatan Sandi Husada, 14(1), 201–210. https://doi.org/10.35816/JIKSH.V14I1.324
Kiosia, A., Dagbasi, A., Berkley, J. A., Wilding, J. P. H., Prendergast, A. J., Li, J. V, Swann, J., Mathers, J. C., Kerac, M., & Morrison, D. (2024). The double burden of malnutrition in individuals: Identifying key challenges and re‐thinking research focus. Nutrition Bulletin, 49(2), 132–145.
McCauley, H., Lowe, K., Furtado, N., Mangiaterra, V., & van den Broek, N. (2022). What are the essential components of antenatal care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation. BJOG: An International Journal of Obstetrics & Gynaecology, 129(6), 855–867.
Mooldijk, S. S., Licher, S., & Wolters, F. J. (2021). Characterizing demographic, racial, and geographic diversity in dementia research: a systematic review. JAMA Neurology, 78(10), 1255–1261.
Odchigue, G. (2025). Knowledge, Attitude, and Nutritional Intervention on the Quality of Antenatal Care Among Pregnant Women. Journal of Interdisciplinary Perspectives, 3(5), 263–273.
Odhiambo, J. F., Pankey, C. L., Ghnenis, A. B., & Ford, S. P. (2020). A review of maternal nutrition during pregnancy and impact on the offspring through development: evidence from animal models of over-and undernutrition. International Journal of Environmental Research and Public Health, 17(18), 6926.
Otto, I. M., Reckien, D., Reyer, C. P. O., Marcus, R., Le Masson, V., Jones, L., Norton, A., & Serdeczny, O. (2017). Social vulnerability to climate change: a review of concepts and evidence. Regional Environmental Change, 17(6), 1651–1662.
Wati, E. K., Murwani, R., Kartasurya, M. I., & Sulistiyani, S. (2024). Determinants of chronic energy deficiency (CED) incidence in pregnant women: A cross-sectional study in Banyumas, Indonesia. Narra J, 4(1), e742–e742. https://doi.org/10.52225/NARRA.V4I1.742
Woods-Jaeger, B. A., Cho, B., Sexton, C. C., Slagel, L., & Goggin, K. (2018). Promoting resilience: Breaking the intergenerational cycle of adverse childhood experiences. Health Education & Behavior, 45(5), 772–780.
World Health Organization. (2018). WHO recommendations on antenatal care for a positive pregnancy experience – Highlights and Key Messages.
World Health Organization. (2021). WHO antenatal care recommendations for a positive pregnancy experience. Nutritional interventions update. In World Health Organization.
Zewude, S. B., Beshah, M. H., Ahunie, M. A., Arega, D. T., & Addisu, D. (2024). Undernutrition and associated factors among pregnant women in Ethiopia. A systematic review and meta-analysis. Frontiers in Nutrition, 11, 1347851. https://doi.org/10.3389/FNUT.2024.1347851/TEXT
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Aniek Luftyannisa, Arief Prijatna
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under aCreative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
