The Effect of Chronic Energy Deficiency on the Incidence of Stunting in Childern Aged 24-59 Months
Abstract
Chronic Energy Deficiency (CED) during pregnancy is a significant public health concern with long-term effects on maternal and child health. The study explores the impact of maternal CED on stunting in children aged 24-59 months in Ngariboyo Public Health Center, where the prevalence of CED among pregnant women was 11.01% in 2023, and stunting affected 8.2% of children. The primary aim of this study is to determine the relationship between maternal CED and the incidence of stunting in the target population. Employing an analytical observational approach, this case-control study included 32 children with stunting as the case group and 64 non-stunted children as the control group, selected through random sampling methods. Data on maternal CED were obtained from maternal and child health records, while stunting data were gathered via
questionnaires. The analysis utilized chi-square and Mantel-Haenszel common odds ratio tests to evaluate the association. The results indicated a significant association (p=0.021) between maternal CED and stunting, with an odds ratio of 3.201, suggesting that mothers with CED have a 3.2 times higher risk of giving birth to stunted children compared to mothers without CED. The study concludes that maternal CED is a crucial factor contributing to stunting in children. Therefore, interventionssuch as early identification and nutritional education for pregnant women are essential for stunting prevention. The findings emphasize the need for targeted public health policies to address maternal nutrition in rural settings.
Full text article
References
[1] A. L. Thompson et al., “Maternal undernutrition and pregnancy outcomes,” The Lancet Global Health, vol. 8, no. 9, pp. e1139–e1149, 2020.
[2] S. C. Kozuki et al., “Maternal nutritional status and fetal growth,” American Journal of Clinical Nutrition, vol. 112, no. 6, pp. 1552–1560, 2020.
[3] R. Black et al., “Maternal and child undernutrition,” The Lancet, vol. 401, pp. 951–966, 2023.
[4] L. Victora et al., “Global nutrition challenges,” BMJ Global Health, vol. 6, no. 4, 2021.
[5] J. Hoddinott et al., “The economic impacts of stunting,” World Development, vol. 146, 2021.
[6] A. Prendergast and J. Humphrey, “The stunting syndrome,” Maternal & Child Nutrition, vol. 20, no. 1, 2024.
[7] P. Christian et al., “Maternal nutrition and child growth,” Nature Reviews Endocrinology, vol. 19, pp. 121–134, 2023.
[8] S. Bhutta et al., “Interventions for maternal and child nutrition,” The Lancet, vol. 401, pp. 1051–1065, 2023.
[9] UNICEF, WHO, World Bank, “Levels and trends in child malnutrition,” Lancet Child Adolesc Health, vol. 7, 2023.
[10] N. Aryastami et al., “Low birth weight and stunting,” BMC Nutrition, vol. 7, 2021.
[11] A. Dewey, “Reducing stunting through maternal nutrition,” Food and Nutrition Bulletin, vol. 41, no. 2, 2020.
[12] M. Smith et al., “Fetal programming and growth failure,” Nutrients, vol. 14, no. 18, 2022.
[13] D. Ruel et al., “Nutrition-sensitive interventions,” The Lancet Global Health, vol. 9, 2021.
[14] L. Leroy et al., “Antenatal nutrition programs,” Public Health Nutrition, vol. 24, no. 18, 2021.
[15] F. Khairani et al., “Maternal chronic energy deficiency and stunting,” Nutrients, vol. 15, no. 4, 2023.
[16] R. Purwitaningtyas et al., “Maternal undernutrition and child growth,” BMC Public Health, vol. 23, 2023.
[17] S. Tessema et al., “Breastfeeding and stunting,” Maternal & Child Nutrition, vol. 17, 2021.
[18] M. Lassi et al., “Postnatal nutrition and growth,” Nutrients, vol. 13, 2021.
[19] A. Rachmi et al., “Health system approaches to stunting,” Health Policy and Planning, vol. 37, 2022.
[20] T. Beal et al., “Global trends in child stunting,” Nature Food, vol. 4, 2023.
[21] S. Suriani et al., “Determinants of stunting in rural settings,” International Journal of Environmental Research and Public Health, vol. 19, 2022.
[22] J. Kim et al., “Community-based nutrition interventions,” Global Health Action, vol. 15, 2022.
[23] WHO, “Antenatal nutritional interventions,” BMJ Global Health, vol. 7, 2022.
[24] D. Rahmawati et al., “Maternal nutrition and child height-for-age,” BMC Pregnancy and Childbirth, vol. 24, 2024.
[25] S. Christian et al., “Intergenerational malnutrition,” Nutrients, vol. 16, no. 2, 2024.
[26] M. R. Setiawan et al., “Case–control study design in public health research,” BMC Medical Research Methodology, vol. 21, 2021.
[27] A. Pandey and S. Aggarwal, “Observational study designs: Applications and limitations,” Journal of Clinical Epidemiology, vol. 134, pp. 1–7, 2021.
[28] J. L. Fleiss et al., “Sample size determination in case–control studies,” Statistics in Medicine, vol. 40, no. 12, pp. 2691–2702, 2021.
[29] L. Rothman, S. Greenland, and T. Lash, “Modern epidemiologic methods,” International Journal of Epidemiology, vol. 50, no. 1, pp. 30–38, 2021.
[30] S. Hulley et al., “Designing clinical and observational research,” The Lancet, vol. 398, no. 10303, pp. 1027–1036, 2021.
[31] World Health Organization, “WHO recommendations on antenatal nutritional assessment,” BMJ Global Health, vol. 7, 2022.
[32] J. Gibson, “Principles of nutritional assessment,” Public Health Nutrition, vol. 25, no. 9, pp. 2525–2532, 2022.
[33] K. Pearce, “Analysis of case–control studies,” International Journal of Epidemiology, vol. 49, no. 5, pp. 1474–1483, 2020.
[34] D. Kleinbaum and M. Klein, “Categorical data analysis in epidemiology,” Statistics in Medicine, vol. 41, no. 2, pp. 223–240, 2022.
[35] World Medical Association, “Ethical principles for medical research involving human subjects,” Journal of the American Medical Association, vol. 326, no. 21, pp. 2191–2194, 2021.
[36] A. Prendergast and J. Humphrey, “The stunting syndrome in developing countries,” Maternal & Child Nutrition, vol. 20, no. 1, 2024.
[37] R. Black et al., “Maternal and child undernutrition: global and regional trends,” The Lancet, vol. 401, pp. 951–966, 2023.
[38] P. Christian et al., “Maternal nutrition and fetal growth programming,” American Journal of Clinical Nutrition, vol. 117, no. 2, pp. 345–356, 2023.
[39] S. Bhutta et al., “Intergenerational transmission of malnutrition,” The Lancet Global Health, vol. 11, no. 2, 2023.
[40] J. Hoddinott et al., “Early-life nutrition and long-term outcomes,” World Development, vol. 162, 2023.
[41] M. Lassi et al., “Postnatal interventions mitigating maternal undernutrition,” Nutrients, vol. 15, no. 7, 2023.
[42] S. Tessema et al., “Breastfeeding, infection, and child growth,” Maternal & Child Nutrition, vol. 18, no. 4, 2022.
[43] T. Beal et al., “Environmental and health service determinants of stunting,” Nature Food, vol. 4, pp. 213–222, 2023.
Authors
Copyright (c) 2025 Nisa Khoirotul Qoni'ah, Astuti Setiyani, Nurlailis Saadah, Sulikah Sulikah

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 a Creative Commons Attribution-ShareAlikel 4.0 International (CC BY-SA 4.0) 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 (See The Effect of Open Access).