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Cumulative High-Risk Pregnancy Complications and Stunting Risk in Indonesian Children Under Five: A DOHaD Framework

Widyawati Widyawati1, Hafifah Ristandiati2

  • 1Department of Pediatric and Maternity Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Farmako, Sekip Utara, Kec. Depok, Kabupaten Sleman, Daerah Istimewa Yogyakarta, Daerah Istimewa Yogyakarta, ID.

Asian/Pacific Island Nursing Journal
|January 30, 2026
PubMed

Insights

High-risk pregnancy complications significantly increase stunting risk in Indonesian children. Addressing cumulative prenatal risks through integrated care is crucial for prevention, supporting the DOHaD hypothesis.

Area of Science:

  • Pediatrics
  • Public Health
  • Developmental Origins of Health and Disease (DOHaD)

Background:

  • Stunting affects 21.6% of Indonesian children under five.
  • High-risk pregnancy (HRP) complications are a potential risk factor for stunting.
  • The DOHaD framework links prenatal exposures to long-term health outcomes.

Purpose of the Study:

  • To examine the cumulative effects of HRP complications on stunting risk in Indonesian children.
  • To control for socioeconomic confounders in the analysis.

Main Methods:

  • Retrospective study of 450 children (12-59 months) in Sleman Regency, Indonesia.
  • Data from maternal records, MCH handbooks, and health post reports.
  • Multivariate logistic regression adjusted for maternal education, family income, and antenatal care visits.

Main Results:

  • Mothers of stunted children had higher rates of HRP complications (68.7% vs. 32.0%).
  • Multiple HRP complications (≥2) showed the strongest association with stunting (aOR=5.80).
  • Individual complications like anemia (aOR=3.21) and pre-eclampsia (aOR=4.37) also increased risk. Maternal education, income, and antenatal care visits were protective.

Conclusions:

  • A dose-response relationship exists between cumulative HRP complications and stunting, supporting the DOHaD hypothesis.
  • Current antenatal care focusing on single risk factors may be insufficient.
  • Integrated prenatal care addressing cumulative risks is essential for stunting prevention in Indonesia.
Abstract

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