The Influence of Interpregnancy Interval and Iron Tablet Adherence on the Occurrence of Anemia Among Pregnant Women
DOI:
https://doi.org/10.26630/jk.v16i3.5347Keywords:
Maternal health, Iron–folic acid adherence, Pregnant womenAbstract
Anemia in pregnancy is a significant public health concern that contributes to maternal morbidity, adverse pregnancy outcomes, and neonatal complications. This study aimed to analyze the effects of the interpregnancy interval and adherence to iron–folic acid (IFA) tablet use on the incidence of anemia among pregnant women. A cross-sectional analytic survey was conducted in Tanjung Sari District, Lampung, Indonesia, involving 114 pregnant women selected through purposive random sampling from a total population of 334, including pregnant women aged 18–45 years in the first or second trimester, with at least one previous pregnancy, complete ANC records, and willingness to participate. Data were collected through structured questionnaires, anthropometric measurements, and documentation review. Anemia was assessed based on hemoglobin levels, while interpregnancy interval and IFA adherence were measured using standardized tools. Bivariate analysis was performed using the chi-square test, and multivariate analysis employed logistic regression to identify predictive factors. Results revealed that 40.4% of respondents were anemic. Pregnant women with an interpregnancy interval of less than 24 months were more likely to experience anemia compared to those with an interval of 24 months or more (p = 0.002). In addition, poor adherence to IFA tablet consumption was strongly associated with a higher prevalence of anemia (p<0.001). Logistic regression confirmed both interpregnancy interval and IFA adherence as significant predictors of anemia. Maintaining an optimal interpregnancy interval and improving adherence to IFA supplementation are critical strategies to prevent anemia during pregnancy.
References
Alfiani, F., Utami, A. M., Zakiyah, N., Daud, N. A. A., Suwantika, A. A., & Puspitasari, I. M. (2025). Cost-Effectiveness Analysis of Multiple Micronutrient Supplementation (MMS) Compared to Iron Folic Acid (IFA) in Pregnancy: A Systematic Review. International Journal of Women’s Health, 17(March), 639–649. https://doi.org/10.2147/IJWH.S489159
Anato, A., & Reshid, M. (2025). Effect of nutrition education and iron-folic acid supplementation on anemia among pregnant women in Ethiopia: a quasi-experimental study. Scientific Reports, 15(1), 1–10. https://doi.org/10.1038/s41598-025-87957-x
Beyene, F. Y., Wudineh, K. G., Bantie, S. A., & Tesfu, A. A. (2025). Effect of short inter-pregnancy interval on perinatal and maternal outcomes among pregnant women in SSA 2023: Systematic review and meta-analysis. PLoS ONE, 20(1), 1–23. https://doi.org/10.1371/journal.pone.0294747
Bhatnagar, R. S., & Padilla-Zakour, O. I. (2021). Plant-based dietary practices and socioeconomic factors that influence anemia in India. Nutrients, 13(10), 1–19. https://doi.org/10.3390/nu13103538
Buciu, V. B., Ciurescu, S., Șerban, D. M., Novacescu, D., Nicoleta, N., Tomescu, L., Rusu, E. L., Sas, I., Ionac, M., & Chiriac, V. D. (2025). The Compounded Risk of Maternal Anemia and Preeclampsia: Neonatal Outcomes and Predictive Modeling in a Low-Resource Tertiary Center. Journal of Clinical Medicine, 14(14). https://doi.org/10.3390/jcm14145051
Engidaw, M. T., Lee, P., Fekadu, G., Mondal, P., & Ahmed, F. (2025). Effect of Nutrition Education during Pregnancy on Iron-Folic Acid Supplementation Compliance and Anemia in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. Nutrition Reviews, 83(7), e1472–e1487. https://doi.org/10.1093/nutrit/nuae170
Haque, N. B., Mihrshahi, S., & Haider, R. (2023). Peer counselling as an approach to improve complementary feeding practices: a narrative review. Journal of Health, Population and Nutrition, 42(1). https://doi.org/10.1186/s41043-023-00408-z
Hassen, T. A., Harris, M. L., Shifti, D. M., Beyene, T., Khan, M. N., Feyissa, T. R., & Chojenta, C. (2024). Effects of short inter-pregnancy/birth interval on adverse perinatal outcomes in the Asia-Pacific region: A systematic review and meta-analysis. PLoS ONE, 19(7 July), 1–19. https://doi.org/10.1371/journal.pone.0307942
Locks, L. M., Bhaise, S., Dhurde, V., Gugel, A., Lauer, J., Shah, M., Goghari, A., Hibberd, P. L., & Patel, A. (2024). The prevalence of anemia during pregnancy and its correlates vary by trimester and hemoglobin assessment method in Eastern Maharashtra, India. Maternal and Child Nutrition, 20(4), 1–14. https://doi.org/10.1111/mcn.13684
Ministry of Health Republic Indonesia. (2023). Indonesia Health Profile 2023. Jakarta: Ministry of Health Republic Indonesia.
Nasruddin, H., Faisal Syamsu, R., & Permatasari, D. (2021). Angka Kejadian Anemia Pada Remaja di Indonesia. Cerdika: Jurnal Ilmiah Indonesia, 1(4), 357–364. https://doi.org/10.59141/cerdika.v1i4.66
Pokhrel, A., Bhatta, B., & Adhikari, A. (2024). Compliance to Iron Folic Acid Supplementation and its associated factors among post-partum mothers of Bharatpur Metropolitan. MedRxiv, 2024.07.18.24310631. https://doi.org/10.1101/2024.07.18.24310631
Putri, T. F., & Fauzia, F. R. (2022). Hubungan Konsumsi Sumber Zat Besi Dengan Kejadian Anemia Pada Remaja Putri Smp Dan Sma Di Wilayah Bantul. Jurnal Ilmu Keperawatan Dan Kebidanan, 13(2), 400–411. https://doi.org/10.26751/jikk.v13i2.1540
Seidu, H., Gaa, P. K., & Mogre, V. (2024). Adherence to Iron and Folic Acid Supplementation Among Pregnant Women From Northern Ghana. Nutrition and Metabolic Insights, 17. https://doi.org/10.1177/11786388231218664
Umezuluike, B. S., Anikwe, C. C., Nnachi, O. C., Iwe, B. C. A., Ifemelumma, C. C., & Dimejesi, I. B. O. (2021). Correlation of platelet parameters with adverse maternal and neonatal outcomes in severe preeclampsia: A case-control study. Heliyon, 7(12). https://doi.org/10.1016/j.heliyon.2021.e08484
Wedderburn, C. J., Ringshaw, J. E., Donald, K. A., Joshi, S. H., Subramoney, S., Fouche, J. P., Stadler, J. A. M., Barnett, W., Rehman, A. M., Hoffman, N., Roos, A., Narr, K. L., Zar, H. J., & Stein, D. J. (2022). Association of Maternal and Child Anemia with Brain Structure in Early Life in South Africa. JAMA Network Open, 5(12), E2244772. https://doi.org/10.1001/jamanetworkopen.2022.44772
Winarni, S., Shaluhiyah, Z., Sulistyawati, S., Lisnawati, N., Hulaila, A., & Chumair, N. O. (2024). Knowledge, Attitudes, Eating Practices, and Iron (Fe) Consumption among Adolescent Girls (Aged 10-18 Years) in Central Java, Indonesia. The Open Public Health Journal, 17(1), 1–10. https://doi.org/10.2174/0118749445352293241105110603
World Health Organization. (2022). WHO recommendations on antenatal care for a positive pregnancy experience (updated 2022). Geneva: World Health Organization.
World Health Organization. (2023a). Anaemia fact sheet. Geneva: World Health Organization.
World Health Organization. (2023b). Anaemia in women and children — data and statistics. Geneva: World Health Organization.
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