Tesis

Anemia and Its Risk Factors in Pregnant Women: A CrossSectional Study during the COVID-19 Pandemic in East Lombok District, Indonesia = Anemia dan Faktor Risikonya pada Ibu Hamil: Studi Potong Lintang selama Pandemi COVID-19 di Kabupaten Lombok Timur, Indonesia.

Background: Maternal anemia is a major public health issue that has detrimental effects on pregnancy and birth outcomes. The threat of food insecurity and nutritional deficiencies is growing as a result of the COVID-19 pandemic. The aim of this study was to determine the prevalence and risk factors of anemia among pregnant women in East Lombok during the pandemic. Materials and Methods: This cross-sectional study is part of an observational cohort study entitled “UKRI-GCRF Action Against Stunting Hub (AASH)” in East Lombok, from August 2021 to February 2022. Data were collected from pregnant women (aged 18-40 years) in their third trimester, including MUAC measurements, structured questionnaires, and 1x24-hour dietary recall. The complete blood count was performed to determine hemoglobin; Kato-Katz to identify intestinal worm infections. The adjusted odd ratios (AOR) for the factors associated with anemia were determined using logistic regression analysis. Results: Of the total 446 women in the third trimester, 40.8% had anemia. During the COVID-19 pandemic, 74.7% and 28.9% reported a decrease in household income and food expenditure, respectively. Medium to high coping strategies, indicating food insecurity, was reported by 47%. About 6.5% of women were infected with intestinal helminth (mostly from Trichuris trichiura) and 19.1% had inadequate ANC ( < 6 visits) throughout pregnancy. In the multivariate analysis, anemia was found to be significantly associated with chronic energy deficiency (AOR = 1.87; 95% CI: 1.04, 3.38), non-use of contraception (AOR = 1.60; 95% CI: 1.03, 2.48), and inadequate dietary diversity (AOR = 1.59; 95% CI: 1.03, 2.47). Younger age ( < 25 years) was a significant determinant of anemia in bivariate analyses. Conclusion: CED, non-use of contraception, and inadequate dietary diversity were major contributors to anemia in pregnancy. Multisectoral stakeholders and healthcare practitioners should collaborate to develop and implement public health policies and intervention programs to alleviate anemia in East Lombok.
Keywords: anemia prevalence, pregnant women, chronic energy deficiency (CED), family planning, dietary diversity, COVID-19 pandemic



Latar Belakang: Anemia maternal merupakan masalah kesehatan masyarakat utama yang memiliki efek merugikan pada hasil kehamilan dan kelahiran. Ancaman kerawanan pangan dan kekurangan gizi semakin meningkat akibat pandemi COVID-19. Tujuan penelitian ini adalah untuk mengetahui prevalensi dan faktor risiko anemia pada ibu hamil di Kabupaten Lombok Timur pada masa pandemi. Bahan dan Metode: Studi cross-sectional ini merupakan bagian dari studi kohort observasional berjudul “UKRI-GCRF Action Against Stunting Hub (AASH)” di Kabupaten Lombok Timur. Data dikumpulkan dari Agustus 2021 hingga Februari 2022, pada ibu hamil (usia 18-40 tahun) trimester ketiga, meliputi pengukuran LILA, wawancara kuesioner terstruktur, dan recall diet 1x24 jam. Perhitungan darah lengkap untuk mengetahui hemoglobin; Kato-Katz untuk mengidentifikasi adanya infeksi cacing usus. Adjusted Odd Ratio (AOR) untuk faktor-faktor yang berhubungan dengan anemia ditentukan menggunakan analisis regresi logistik. Hasil: Dari total 446 wanita hamil trimester ketiga, 40.8% mengalami anemia. Selama pandemi COVID-19, 74.7% dan 28.9% ibu melaporkan penurunan pendapatan rumah tangga dan pengeluaran makanan. Strategi penanggulangan kerawanan pangan (coping strategies) sedang dan tinggi dilaporkan oleh 47% responden. 6,5% ibu terinfeksi cacing usus (mayoritas cacing Trichuris trichiura), dan 19,1% memiliki ANC yang tidak memadai ( < 6 kunjungan) selama kehamilan. Dalam analisis multivariat, anemia ditemukan secara signifikan berhubungan dengan kurang energi kronis (AOR = 1 .87; 95% CI: 1.04, 3.38), tidak menggunakan kontrasepsi (AOR = 1.60; 95% CI: 1.03, 2.48), dan rendahnya keragaman konsumsi pangan (AOR = 1 .59; 95% CI: 1 .03, 2.47). Usia muda ( < 25 tahun) merupakan faktor penentu anemia dalam analisis bivariat. Kesimpulan: KEK, tidak menggunakan metode KB sebelum kehamilan, dan rendahnya keragaman konsumsi pangan merupakan kontributor utama anemia pada kehamilan. Pemangku kepentingan multisektoral dan praktisi kesehatan harus berkolaborasi untuk mengembangkan dan menerapkan kebijakan kesehatan masyarakat serta program intervensi untuk mengatasi anemia di Lombok Timur.
Kata kunci: prevalensi anemia, ibu hamil, kurang energi kronis (KEK), keluarga berencana (KB), keragaman konsumsi pangan, pandemi COVID-19