The role of prematurity as a risk factor for stunting and its interaction with birth anthropometry in infants and toddlers
DOI: https://doi.org/10.56922/mchc.v4i9.2024
Birth Anthropometry Low Birth Weight Prematurity Stunting Toddler
Abstract
Background: Stunting remains a major public health issue, particularly in developing countries, and is strongly influenced by conditions during pregnancy and early life. Prematurity and birth anthropometry, such as low birth weight and short birth length, are believed to be key determinants that increase the risk of growth failure in infants and toddlers.
Purpose: to analyze the role of prematurity as a risk factor for stunting and examine its interaction with birth anthropometry among infants and toddlers.
Method: This analytic observational study employed a case–control design involving 78 children aged 24–59 months, consisting of 39 stunted and 39 non-stunted children selected through total sampling. Data on birth history and nutritional status were collected, and stunting was determined using height-for-age z-scores (HAZ). Data analysis included chi-square tests for bivariate associations and logistic regression for multivariate analysis and interaction testing.
Results: Among all respondents, 28.2% were born prematurely and 24.4% had low birth weight. Prematurity showed a significant relationship with stunting (p = 0.002), with premature children having a 3.12-fold higher risk of stunting. Multivariate analysis confirmed prematurity as a significant predictor (OR = 4.71; p = 0.004), while low birth weight also contributed significantly (OR = 2.97; p = 0.018). The interaction between prematurity and low birth weight demonstrated the strongest effect (OR = 5.48; p = 0.010), indicating that children with both risk factors have the highest likelihood of stunting.
Conclusion: Prematurity and low birth weight are significant risk factors for stunting, and their interaction substantially increases the risk of growth failure. Strengthening maternal care, preventing premature births, and optimizing neonatal management for at-risk infants are essential strategies to reduce stunting prevalence.
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Alanazi, M., Altawili, M. A., Khayyal, A. I., Alahmari, A. S., Alhakami, A. A., Alshehri, A. M. A., & Khayyal S, A. (2024). Impact of early nutrition interventions on the growth and development of preterm infants: a narrative review. Cureus, 16(2).
Andriani, H., Arsyi, M., Sutrisno, A. E., Waits, A., & Rahmawati, N. D. (2025). Projecting the impact of a national strategy to accelerate stunting prevention in East Nusa Tenggara, Indonesia, using the Lives Saved Tool. Narra J, 5(1), e1462.
Asna, A. F., & Syah, M. N. H. (2023). Chronic energy malnutrition in mothers associated with stunting. Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics), 11(2), 77-84.
Bala, F. E., McGrattan, K. E., Valentine, C. J., & Jadcherla, S. R. (2024). A narrative review of strategies to optimize nutrition, feeding, and growth among preterm-born infants: implications for practice. Advances in Nutrition, 15(11), 100305.
Cha, J. H., Kang, E., Na, J. Y., Ryu, S., Choi, Y. J., & Kim, J. H. (2025). Growth Trajectories of Children Born Preterm and Full-Term with Low Birth Weight to Preschool Ages: A Nationwide Study. The Journal of Clinical Endocrinology & Metabolism, 110(2), e283-e293.
Choudhary, T. S., Kumar, M., Sinha, B., Shaikh, S., Mazumder, S., Taneja, S., & Bhandari, N. (2022). Anthropometric indicators as predictors of mortality in early life among low birthweight Indian infants. Frontiers in Nutrition, 9, 884207.
Christian, P., Lee, S. E., Angel, M. D., Adair, L. S., Arifeen, S. E., Ashorn, P., & Black, R. E. (2013). Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low-and middle-income countries. International journal of epidemiology, 42(5), 1340-1355.
Cuestas, E., & Rizzotti, A. (2024). Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants. Clinical and Experimental Pediatrics, 68(4), 287.
Ekoriano, M., Widiyanto, A., Muthmainnah, M., Devi, Y. P., Cahyono, B. E., Nafsi, I., & Widodo, T. (2025). Profile and factors associated with low birth weight in Indonesia: A national data survey. Rural and Remote Health, 25(1), 1-9.
Huriah, T., & Nurjannah, N. (2020). Risk factors of stunting in developing countries: A scoping review. Open Access Macedonian Journal of Medical Sciences, 8(F), 155-160.
Islam, B., Ibrahim, T. I., Wang, T., Wu, M., & Qin, J. (2025). Current trends in household food insecurity, dietary diversity, and stunting among children under five in Asia: a systematic review. Journal of Global Health, 15, 04049.
Jamaluddine, Z., Sharara, E., Helou, V., El Rashidi, N., Safadi, G., El-Helou, N., & Campbell, O. M. (2023). Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review. Archives of Disease in Childhood, 108(12), 956-969.
Jasper, E. A., Cho, H., Breheny, P. J., Bao, W., Dagle, J. M., & Ryckman, K. K. (2021). Perinatal determinants of growth trajectories in children born preterm. PLoS One, 16(1), e0245387.
Kresnawati, W., Pandie, P. J., & Rohsiswatmo, R. (2025). Very low birth weight infant outcomes in a resource-limited setting: a five-year follow-up study. Frontiers in Pediatrics, 13, 1581033.
Li, Y., Wen, J., Jiang, Q., & Cui, H. (2025). Different Catch-Up Growth Patterns in Very Preterm and Small for Gestational Age Infants. Clinical Pediatrics, 64(6), 780-790.
Limijadi, E. K. S., & Devi, K. S. (2024). Impact of nutritional interventions and antenatal care on stunting in Indonesia: A systematic review. In RSF Conference Series: Business, Management and Social Sciences (Vol. 4, No. 1, p. 228). Research Synergy Foundation.
Martinez, E. A. P., & Perez, G. K. K. (2024). Risk Factors and Complications in Premature and Low Birth Weight Newborns. Retrieved from: https://www.stephypublishers.com/tnhcr/pdf/TNHCR.MS.ID.000532.pdf
Meliati, L., Rahfiludin, M. Z., Kartini, A., & Jati, S. P. (2025). Determinants of malnutrion in children aged 6-36 months. AcTion: Aceh Nutrition Journal, 10(2), 311.
Mulyani, A. T., Khairinisa, M. A., Khatib, A., & Chaerunisaa, A. Y. (2025). Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction—A Narrative Review. Nutrients, 17(9), 1493.
Nafisa, T. H., Saptanto, A., Ratnaningrum, K., & Prihardini, O. R. (2025). Chronic Energy Deficiency in Pregnancy is An Influential Factor in the Occurrence of Stunting in Toddlers. Jurnal Ilmu Kedokteran (Journal of Medical Science), 19(1), 35-43.
Putri, T. A., Salsabilla, D. A., & Saputra, R. K. (2021). The effect of low birth weight on stunting in children under five: a meta analysis.
Quamme, S. H., & Iversen, P. O. (2022). Prevalence of child stunting in Sub-Saharan Africa and its risk factors. Clinical Nutrition Open Science, 42, 49-61.
Ratnawati, R., Kartasurya, F. M. I., Kartini, A., & Noe, E. R. (2025). Prenatal Risk Factors for Stunting in Children aged 12-24 Months in Central Java, Indonesia. Bangladesh Journal of Medical Science, 24(2), 579-588.
Safitri, H. O., Fauziningtyas, R., Indarwati, R., Efendi, F., & McKenna, L. (2022). Determinant factors of low birth weight in Indonesia: Findings from the 2017 Indonesian demographic and health survey. Journal of Pediatric Nursing, 63, e102-e106.
Sartika, A. N., Khoirunnisa, M., Meiyetriani, E., Ermayani, E., Pramesthi, I. L., & Nur Ananda, A. J. (2021). Prenatal and postnatal determinants of stunting at age 0–11 months: A cross-sectional study in Indonesia. Plos one, 16(7), e0254662.
Svefors, P., Sysoev, O., Ekstrom, E. C., Persson, L. A., Arifeen, S. E., Naved, R. T., & Selling, K. (2019). Relative importance of prenatal and postnatal determinants of stunting: data mining approaches to the MINIMat cohort, Bangladesh. BMJ open, 9(8), e025154.
Thahir, A. I. A., Li, M., Holmes, A., & Gordon, A. (2023). Exploring factors associated with stunting in 6-month-old children: A population-based cohort study in Sulawesi, Indonesia. Nutrients, 15(15), 3420.
Vaivada, T., Akseer, N., Akseer, S., Somaskandan, A., Stefopulos, M., & Bhutta, Z. A. (2020). Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. The American journal of clinical nutrition, 112, 777S-791S.Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. The American journal of clinical nutrition, 112, 777S-791S.
Vats, H., Walia, G. K., Saxena, R., Sachdeva, M. P., & Gupta, V. (2024). Association of low birth weight with the risk of childhood stunting in low-and middle-income countries: A systematic review and meta-analysis. Neonatology, 121(2), 244-257.
Vizzari, G., Morniroli, D., Tiraferri, V., Macchi, M., Gangi, S., Consales, A., & Giannì, M. L. (2023). Postnatal growth of small for gestational age late preterm infants: determinants of catch-up growth. Pediatric Research, 94(1), 365-370.
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