Dietary Intake and Its Association with Chronic Energy Deficiency Among Pregnant Women in South Lampung Regency, Indonesia: A Case-Control Study

Authors

  • Dian Utama Pratiwi Putri Universitas Mitra indonesia
  • Anita Kurnia Universitas Mitra indonesia
  • Endang Budiati Universitas Mitra Indonesia
  • Sugeng Eko Irianto Universitas Mitra Indonesia

DOI:

https://doi.org/10.36568/jone.v4i4.769

Keywords:

Chronic Energy Deficiency (CED), pregnant woman, dietary intake, maternal knowledge, social environment

Abstract

Chronic energy deficiency (CED) remains a major nutritional problem among pregnant women in Indonesia, contributing to adverse maternal and neonatal outcomes such as low birth weight (LBW), anemia, and pregnancy-related complications. According to data from the South Lampung District Health Office, the prevalence of CED among pregnant women increased from 5.9% in 2023 to 6.38% in 2024. This study aimed to identify factors associated with CED among pregnant women in South Lampung Regency in 2026. An analytical survey using a case–control design was conducted among a target population of 974 pregnant women. A sample of 182 participants (91 cases and 91 controls) was selected using stratified random sampling followed by simple random sampling. Data were analyzed using univariate analysis, bivariate chi-square tests, and multivariate multiple logistic regression. Bivariate analysis revealed significant associations between CED and dietary intake (p < 0.001; OR = 6.650), infectious diseases (p = 0.005; OR = 2.451), maternal knowledge (p = 0.001; OR = 2.820), and the social environment (p = 0.001; OR = 2.891). Physical activity was not significantly associated with CED (p = 0.875). Multiple logistic regression identified dietary intake as the strongest predictor of CED (p < 0.001; adjusted OR = 6.866) after controlling for maternal knowledge and social environment. In conclusion, dietary intake, infectious diseases, maternal knowledge, and the social environment are key factors associated with CED among pregnant women in South Lampung Regency. Priority should be given to improving maternal nutritional intake through targeted supplementary feeding programs aligned with national My Plate (Isi Piringku) guidelines, supported by routine monitoring and evaluation.

References

Kementerian Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Republik Indonesia Nomor 41 Tahun 2014 tentang Pedoman Gizi Seimbang. Jakarta: Kementerian Kesehatan RI; 2014.

Kuntari T, Utami U, Widyasari V, Supadmi S, Choironi EA. Chronic energy deficiency in young pregnant women in rural Indonesia: an analysis of basic health survey 2018. J Ners [Internet]. 2024 [cited 2026 Oct 23];19(4):433-40. Available from: https://doi.org/10.20473/jn.v19i4.56196

Hidayatullah MT, Nugraheni SA, Widjanarko B, Kartini A. Integrated situational analysis of chronic energy deficiency to inform a community-based mentoring model in Indonesia. J Kesehat Masy [Internet]. 2026 [cited 2026 Oct 23];21(4):987-1003. Available from: https://doi.org/10.15294/kemas.v21i4.48410

Rahmawati R, Nugroho A, Kania N. Literature review: factors associated with the incidence of chronic energy deficiency in pregnant women. Indones J Glob Health Res [Internet]. 2026 [cited 2026 Oct 23];8(3):263-74. Available from: https://doi.org/10.37287/ijghr.v8i3.1074

Wati EK, Murwani R, Kartasurya MI, Sulistiyani S. Determinants of chronic energy deficiency (CED) incidence in pregnant women: a cross-sectional study in Banyumas, Indonesia. Narra J [Internet]. 2024 [cited 2026 Oct 23];4(1):e742. Available from: https://doi.org/10.52225/narra.v4i1.742

Rachmi R, Marjan AQ, Sufyan DL, Wahyuningsih U. Factors affecting chronic energy deficiency among pregnant women in East Nusa Tenggara Province, Indonesia. J Gizi Pangan [Internet]. 2024 [cited 2026 Oct 23];19(Suppl 1):95-104. Available from: https://doi.org/10.25182/jgp.2024.19.Supp.1.95-104

Azis R, Nurfajriani, Syahruddin AN. Hubungan pengetahuan, pendapatan keluarga dan pola makan dengan kejadian kekurangan energi kronis (KEK) pada ibu hamil. J Kesehat Ilm Indones [Internet]. 2025 [cited 2026 Oct 23];10(2). Available from: https://doi.org/10.51933/health.v10i2.2218

Angkasa D, Iswarawanti DN, Santika O. Food taboo, dietary diversity and prevalence of chronic energy deficiency in pregnant women living in rural area Indonesia. J Keperawatan Padjadjaran [Internet]. 2024 [cited 2026 Oct 23];12(1):13-22. Available from: https://doi.org/10.24198/jkp.v12i1.2263

Bresnahan KA, Tanumihardjo SA. Undernutrition, the acute phase response to infection, and its effects on micronutrient status indicators. Adv Nutr [Internet]. 2014 [cited 2026 Oct 23];5(6):702-11. Available from: https://doi.org/10.3945/an.114.006361

Hutapea LK, Noor MS, Hartoyo E, Triawanti, Sadiqi MA. Risk factors associated with chronic energy deficiency (CED) in pregnant women. Indones Midwifery Health Sci J [Internet]. 2025 [cited 2026 Oct 23];9(3):292-309. Available from: https://doi.org/10.20473/imhsj.v9i3.2025.292-309

Yunita M, Fitri Y, Maharani M. The analysis of factors related to the prevalence of chronic energy deficiency (CED) in pregnant women. J Kebidanan Malahayati [Internet]. 2023 [cited 2026 Oct 23];9(1):82-7. Available from: https://doi.org/10.33024/jkm.v9i1.8965

Dinas Kesehatan Kabupaten Lampung Selatan. Laporan prevalensi KEK pada ibu hamil di wilayah kerja puskesmas tahun 2024. Kalianda: Dinas Kesehatan Kabupaten Lampung Selatan; 2024.

Mufidah R, Pangestuti DR, Widajanti L. Hubungan tingkat kecukupan energi, tingkat aktivitas fisik dan karakteristik keluarga dengan risiko kekurangan energi kronis pada ibu hamil di wilayah kerja Puskesmas Dawe, Kudus. J Kesehat Masy [Internet]. 2016 [cited 2026 Oct 23];4(4):545-51. Available from: https://doi.org/10.14710/jkm.v4i4.14285

Hasanah UN. Analisis karakteristik demografi, pengetahuan, dan dukungan sosial dengan kejadian kurang energi kronis (KEK) pada ibu hamil di Puskesmas Tanah Kali Kedinding Surabaya [thesis on the Internet]. Surabaya: Universitas Airlangga; 2020 [cited 2026 Oct 23]. Available from: http://repository.unair.ac.id

Sunarti NTS, Sulistyowati S, Nurhaeni IDA, Setyowati R. The sociocultural in food selection among pregnant women with chronic energy deficiency: a qualitative study. In: Proceedings of the International Conference on Multidisciplinary Studies (ICoMSi 2024) [Internet]. Atlantis Press; 2025 [cited 2026 Oct 23]. p. 89-99. Available from: https://doi.org/10.2991/978-2-38476-406-8_8

Notoatmodjo S. Metodologi penelitian kesehatan. Jakarta: Rineka Cipta; 2018.

Supariasa IDN, Bakri B, Fajar I. Penilaian status gizi. Jakarta: EGC; 2016.

Hastono SP. Analisis data pada bidang kesehatan. Jakarta: Rajawali Pers; 2016.

Dal N, Tek N. Energy expenditure in healthy pregnant women: a systematic review. Nutr Rev [Internet]. 2025 [cited 2026 Oct 23];83(2):e223-36. Available from: https://doi.org/10.1093/nutrit/nuae017

Lestari N, Subiastutik E. Hubungan pola makan dengan kejadian kekurangan energi kronik pada ibu hamil di Puskesmas Panti Kabupaten Jember. TRILOGI J Ilmu Teknol Kesehat Hum [Internet]. 2026 [cited 2026 Oct 23];7(3). Available from: https://doi.org/10.33650/trilogi.v7i3.16746

Fitrianingtyas I, Pertiwi FD, Rachmania W. Faktor-faktor yang berhubungan dengan kejadian kurang energi kronis (KEK) pada ibu hamil di Puskesmas Warung Jambu Kota Bogor. Hearty [Internet]. 2018 [cited 2026 Oct 23];6(2). Available from: https://doi.org/10.32832/hearty.v6i2.1275

Prasetyo A, Hariastuti I, Sugiharti S, Wijayanti UT, Wahyudianto H, Fuada N, et al. Nutritional and health factors influencing first antenatal visit among pregnant women in Indonesia. Front Public Health [Internet]. 2025 [cited 2026 Oct 23];13:1715230. Available from: https://doi.org/10.3389/fpubh.2025.1715230

Hasanah U, Monica OT, Susanti D, Hariyanti R. Hubungan pendidikan dan pekerjaan dengan kejadian kekurangan energi kronik (KEK) pada ibu hamil di Puskesmas Putri Ayu Kota Jambi. MAHESA Malahayati Health Stud J [Internet]. 2023 [cited 2026 Oct 23];3(8):2375-85. Available from: https://doi.org/10.33024/mahesa.v3i8.10832

Kurniawan DAN, Triawanti T, Noor MS, Djallalluddin D, Qamariah N. Literature review: hubungan pekerjaan dan penghasilan keluarga dengan kejadian kurang energi kronik pada ibu hamil. Homeostasis [Internet]. 2021 [cited 2026 Oct 23];4(1):115-26. Available from: https://doi.org/10.20527/ht.v4i1.3366

Mukkadas H, Salma WO, Cristian Bhinekada IM. Factors related to chronic energy deficiency in pregnant mothers in the Konawe District, Indonesia. J Res Dev Nurs Midw [Internet]. 2021 [cited 2026 Oct 23];18(2):18-20. Available from: http://nmj.goums.ac.ir/article-1-1313-en.html

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Published

2026-10-27

How to Cite

Putri, D. U. P., Kurnia, A., Budiati, E., & Eko Irianto, S. (2026). Dietary Intake and Its Association with Chronic Energy Deficiency Among Pregnant Women in South Lampung Regency, Indonesia: A Case-Control Study . Journal of Nutrition Explorations, 4(4), 644–655. https://doi.org/10.36568/jone.v4i4.769

Issue

Vol. 4 No. 4 (2026): November

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Articles

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