FAKTOR RISIKO BBLR

Faktor Ibu

1. Status Gizi
The odds of giving LBW baby were higher among mothers with body
mass index (BMI) less than 18.50kg/m2 as compared to mothers with
BMI greater than 25 kg/m2 (AOR = 6.7; 95 % CI = (1.2137.14).
Maternal short stature (150 cm) AOR = 3.7; 95 % CI = 1.2211.28)
and khat chewing (AOR = 6.4; 95 % CI =2.4117.10) were risk factors
for low birth weight.

This findings were consistent with a study conducted in India which

revealed that low birth weights were significantly higher among
mothers with height <145 cm and BMI <18.5 kg/m2 [17]. It is also
consistent with studies done in Southwestern Ethiopia and Tanzania
[12, 18].
It is also consistent with another similar study where BMI (<18 kg/m2)
two times prone to deliver low birth weight babies [20]. The mean BMI
<18 kg/m2 were significantly higher in mothers who had LBW babies
compared to those who delivered NBW babies in another case control
study in Iran [19]. This might be because of the fact that
anthropometric measurements directly or indirectly measures
nutritional status. In this case a BMI of less than 18 indicates the
presence of under-nutrition that reveals chronic malnutrition among
adults. Hence; maternal under-nutrition can hinder the growth and
development of fetus in the uterus

2. Usia Ibu

Mothers who were in the age group of less than 20 years were more
likely to deliver low birth weight babies than those mothers in the age
group of 2135 years (AOR = 3.1; (95 % CI = 1.655.73))(Demelash,
2014)
Maternal age was found significantly associated with low birth weight
infants. The younger age group is at risk of having LBW babies
compared to older age group and this finding is consistent with other
studies [10] [13] [22]-[24]. However, there were also studies reported
that the older maternal age is at higher risk in getting LBW infants
[16]. The explanation could relate to maternal nutritional depletion that
presence normally in teenage pregnancy and older age group because
of poor eating pattern. Increased risk of chronic disease such as
hypertension, Diabetes Mellitus and heart disease for advanced
maternal age required them to deliver preterm or their babies
 developed intrauterine growth restriction due to poor maternal health.
(Sutan)
Pada tabel 1 diperoleh p value untuk umur ibu sebesar 0,01, artinya
ada hubungan antara umur ibu dengan kejadian BBLR di RSIA Kasih Ibu
Manado. Nilai OR untuk umur ibu dengan kejadian BBLR sebesar 5,09
(CI 95% 1,89-13,69) yang berarti bahwa umur ibu merupakan faktor
risiko kejadian BBLR di RSIA Kasih Ibu Manado, dimana ibu yang
melahirkan pada usia <20 dan >35 tahun berisiko 5,09 kali lebih besar
untuk melahirkan bayi BBLR daripada ibu yang melahirkan pada umur
20-35 tahun (Berlianti).

3. Usia Kehamilan
4. Paritas
5. Jarak Kehamilan
mothers with birth interval of 2 years and below between the current
and previous birth were more likely to give low birth weight baby than
mothers who gave birth greater than 2 years apart (AOR = 3.2; (95 %
CI =1.586.31)) (Demelash, 2014). Mothers with birth spacing of 2
years and below were more likely to deliver low birth weight baby than
mothers who delivered with birth interval of 2 or more years. This
finding is inline with a study done in India that showed birth interval of
< 2 years were at higher risk to deliver LBW baby [17]. This could be
due to the fact that short inter-pregnancy interval might result in
inadequate replenishment of maternal nutrient stores depleted in the
previous pregnancy and lead to reduced fetal growth.

6. Pendidikan

Mothers who had no formal education were at higher risk to give low
birth weight baby as compared to mothers with tertiary level of
education (AOR = 6; (95 % CI =1.3426.90)). (Demelash, 2014)
Similarly, the study conducted in Nepal and Lahore showed that
maternal education and per capita income of the family per month
were found to be significantly associated with birth weight of the new
born [13, 15]. Education also influences peoples perceptions and
dispositions towards different activities including health activities and
behaviour such as proper maternal feeding practices and maternal
health service utilization

7. Pekerjaan Ibu beban kerja
 Niedhammer et al in 2009 studied 1 124 pregnant women and
showed a significant relationship between physical labor and low birth
weight [6];

in a similar study Vrijkotte et al studied 7 135 pregnant women and

reported significant relation between labor severity and infants low
birth weight [7].

Aminian, 2014. To evaluate the effect of labor or work type on birth

weight, this study showed that farmer women had lower birth
weight infants in comparison to others. This study also indicated that
the mean birth weight of newborns had a significant relation with
working hours per week and months during pregnancy. There
was a significant relation between mothers job and preterm labor in
our study. These studies also showed that physical activity and
fatigue not only could affect the birth weight, but also it could lead to
preterm labor

Ha on 1 222 pregnant women also showed that long-standing (more

than three hours a day) is significantly associated with low birth weight

Rao, 2003 India. The relationship between maternal activity and birth
size was strong for one specific activity, namely fetching water, which
was perceived as a strenuous activity by rural mothers

Banyak peneliti (Simpson, 1993; Keith & Lukas, 1991) berspekulasi

bahwa pekerjaan berat meningkatkan kontraksi rahim dan karena itu
meningkatkan risiko kelahiran prematur. Dasar biologis untuk efek
berbahaya dari pekerjaan berat pada hasil kehamilan telah
diidentifikasi sebagai itu berkurang uterus dan aliran darah plasenta,
sehingga mengurangi pasokan janin oksigen dan nutrisi yang
membatasi pertumbuhan intra-uterine (Lima et al, 1999). Sebaliknya,
waktu luang olahraga, terutama pada trimester kedua diamati untuk
melindungi terhadap persalinan prematur (Misra et al, 1998; Berkowitz
et al, 1983)

Mothers who were merchant by their occupational were 90 % less likely

to deliver low birth weight babies compared to employed mothers
(AOR = 0.1; (95 % CI = 0.020.52)) (Demelash, 2014).
penelitiannya terdapat hubungan yang signifikan antara pekerjaan
dengan kejadian BBLR, dimana ibu yang bekerja memiliki risiko 2,42
kali lebih besar melahirkan bayi BBLR dibandingkan dengan ibu yang
tidak bekerja, hal ini disebabkan karena ibu hamil terus menerus
bekerja selama kehamilan yang dapat mempengaruhi pertumbuhan
 dan perkembangan janin dalam kandungan ibu (Putri dalam Berlianti
Inggit).

8. Penghasilan

Mothers in deprived socio-economic conditions frequently have low

birthweight infants. In those settings, the infants low birthweight
stems primarily from the mothers poor nutrition and health over a
long period of time, including during pregnancy, the high prevalence of
specific and non-specific infections, or from pregnancy complications
underpinned by poverty. Physically demanding work during pregnancy
also contributes to poor foetal growth (WHO, 2004).
Those mothers with monthly income less than 26$ were four times
more likely to give
LBW baby as compared to mothers with monthly income of greater
than 79 $ (AOR = 3.8; (95 % CI = 1.549.41)). (Demelash, 2014).
Similarly, the study conducted in Nepal and Lahore showed that
maternal education and percapita income of the family per month were
found to be significantly associated with birth weight of the new born
[13, 15].

9. Riwayat BBLR

Result of this study has shown, mother with history of LBW infants are
having 4 times risk to get LBW infant compared to mothers with no
history of LBW. Other studies were also reporting the same findings in
their populations [17] [22]. (Sutan)

10.ANC
Regresi Logistik : The odds of low birth weight were higher among
mothers who didnt attend antenatal care for current pregnancy as
compared to mothers who attended ANC (AOR = 2.9;(95 % CI =1.23
6.94). Demelash, 2014). In this study, mothers who encountered
pregnancy related health problems during current pregnancy were at
higher risk to deliver low birth weight baby than mothers who didnt.
This result is similar with a study done in India that showed mothers
with any health problem during pregnancy were two times more likely
to give low birth weight babies.

Faktor Obsetri
1. Hamil Ganda
2. Komplikasi Kehamilan (KPD, perdarahan antepartum, hipertensi
dalam kehamilan, ancaman persalinan prematur, infeksi berat dalam
kehamilan)
In multiple logistic regression analysis; mothers who encountered
pregnancy related health problems during current pregnancy were at
higher risk to deliver low birth weight baby than mothers who didnt
encounter any health problem (AOR = 6.3; (95 % CI = 2.7514.48)
(Demelash, 2014). In this study, mothers who encountered pregnancy
related health problems during current pregnancy were at higher risk
to deliver low birth weight baby than mothers who didnt. This result is
similar with a study done in India that showed mothers with any health
problem during pregnancy were two times more likely to give low birth
weight babies [17]
Low gestational age is a risk factor contributing to LBW infants [13]
[17] [23] [26]. Gestational age plays an important role in determining
infants birth weight. Infants who are delivered prematurely (less than
37 weeks) are at higher risk to have low birth weight infants. The World
Health Organization estimated about one third of low birth weight
infants is caused by prematurity (sutan)