TOO YOUNG TO CARRY: UNDERSTANDING THE DOUBLE BURDEN OF ANEMIA AND EARLY PREGNANCY AMONG ADOLESCENTS IN RURAL TANGERANG

Trisna Amerdista; David Christian; Indri; Muhammad Ikmal Syafii

doi:10.29082/IJNMS/2025/Vol9/Iss3/760

Authors

Trisna Amerdista Faculty of Medicine, Syarif Hidayatullah Jakarta Islamic State University, Banten, Indonesia
David Christian Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia https://orcid.org/0009-0003-6274-5227
Indri Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia
Muhammad Ikmal Syafii Faculty of Medicine, Muhammadiyah University of Jakarta, Jakarta, Indonesia

DOI:

https://doi.org/10.29082/IJNMS/2025/Vol9/Iss3/760

Keywords:

Anemia, Antenatal Care, Indonesia, Pregnant Adolescents, Rural Health

Abstract

Background: Anemia during pregnancy continues to be a significant public health concern, especially among adolescents in low-resource settings. This study examines the prevalence of anemia among pregnant adolescents (<20 years) in Cisoka Puskesmas, Indonesia. Methods: Employing a cross-sectional design with total sampling, we examined medical records from January to December 2024. Hemoglobin levels were measured using Onemed HbCheck Hemoglobin Test Meter, with anemia defined as Hb <11.0 g/dL. Descriptive statistics were analyzed using SPSS 26. Results: Among 76 participants, the prevalence of anemia was 46.1%, peaking in the third trimester (54.3%). Mean hemoglobin levels showed a notable decline across trimesters (11.48 g/dL in the first trimester to 10.43 g/dL in the third trimester). Most participants (67.1%) had inadequate antenatal care (<4 visits). Moderate anemia predominated (51.4%), particularly in the second trimester (62.5%). Conclusion: This study reveals high anemia prevalence among pregnant adolescents in rural Tangerang, closely linked to advanced gestation and inadequate antenatal care. These results highlight the necessity for adolescent-specific iron supplementation and enhanced antenatal services for this vulnerable population.

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References

Adanikin, A. I., Awoleke, J. O., Olofinbiyi, B. A., Adanikin, P. O., & Ogundare, O. R. (2015). Routine Iron Supplementation and Anaemia by Third Trimester in a Nigerian Hospital. Ethiopian Journal of Health Sciences, 25(4), Article 4. https://doi.org/10.4314/ejhs.v25i4.3

Agbozo, F., Abubakari, A., Der, J., & Jahn, A. (2020). Maternal Dietary Intakes, Red Blood Cell Indices and Risk for Anemia in the First, Second and Third Trimesters of Pregnancy and at Predelivery. Nutrients, 12(3), 777. https://doi.org/10.3390/nu12030777

Amoadu, M., Abraham, S. A., Adams, A. K., Akoto-Buabeng, W., Obeng, P., & Hagan, J. E. (2024). Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review. Children, 11(4), Article 4. https://doi.org/10.3390/children11040476

Andriastuti, M., Ilmana, G., Nawangwulan, S. A., & Kosasih, K. A. (2020). Prevalence of anemia and iron profile among children and adolescent with low socio-economic status. International Journal of Pediatrics and Adolescent Medicine, 7(2), 88–92. https://doi.org/10.1016/j.ijpam.2019.11.001

Annan, R. A., Gyimah, L. A., Apprey, C., Edusei, A. K., Asamoah-Boakye, O., Aduku, L. N. E., Azanu, W., & Lutterodt, H. E. (2021). Factors associated with iron deficiency anaemia among pregnant teenagers in Ashanti Region, Ghana: A hospital-based prospective cohort study. PLOS ONE, 16(4), e0250246. https://doi.org/10.1371/journal.pone.0250246

Balarajan, Y., Ramakrishnan, U., Özaltin, E., Shankar, A. H., & Subramanian, S. (2011). Anaemia in low-income and middle-income countries. The Lancet, 378(9809), 2123–2135. https://doi.org/10.1016/S0140-6736(10)62304-5

Beard, J. (2000). Iron Requirements in Adolescent Females. The Journal of Nutrition, 130, 440S-442S. https://doi.org/10.1093/jn/130.2.440S

Churchill, D., Nair, M., Stanworth, S. J., & Knight, M. (2019). The change in haemoglobin concentration between the first and third trimesters of pregnancy: A population study. BMC Pregnancy and Childbirth, 19(1), 359. https://doi.org/10.1186/s12884-019-2495-0

Cohen, C. T., & Powers, J. M. (2024). Nutritional Strategies for Managing Iron Deficiency in Adolescents: Approaches to a Challenging but Common Problem. Advances in Nutrition, 15(5), 100215. https://doi.org/10.1016/j.advnut.2024.100215

Eweis, M., Farid, E. Z., El-Malky, N., Abdel-Rasheed, M., Salem, S., & Shawky, S. (2021). Prevalence and determinants of anemia during the third trimester of pregnancy. Clinical Nutrition ESPEN, 44, 194–199. https://doi.org/10.1016/j.clnesp.2021.06.023

Habib, F., Habib Zein Alabdin ,E., Alenazy ,M., & and Nooh, R. (2009). Compliance to iron supplementation during pregnancy. Journal of Obstetrics and Gynaecology, 29(6), 487–492. https://doi.org/10.1080/01443610902984961

Ikeanyi, E. M., & Ibrahim, A. I. (2015). Does antenatal care attendance prevent anemia in pregnancy at term? Nigerian Journal of Clinical Practice, 18(3), Article 3. https://doi.org/10.4103/1119-3077.151730

Jufar, A. H. (2013). Prevalence of Anemia among Pregnant Women Attending Antenatal Care at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia. Journal of Hematology & Thromboembolic Diseases, 02. https://doi.org/10.4172/2329-8790.1000125

Konje, E. T., Ngaila, B. V., Kihunrwa, A., Mugassa, S., Basinda, N., & Dewey, D. (2022). High Prevalence of Anemia and Poor Compliance with Preventive Strategies among Pregnant Women in Mwanza City, Northwest Tanzania: A Hospital-Based Cross-Sectional Study. Nutrients, 14(18), Article 18. https://doi.org/10.3390/nu14183850

Kumbang, S., Khanikar, A., Konwar, R., & Konwar, S. (2022). Study of hemoglobin levels among pregnant women in different trimesters at a tertiary hospital. Trends in Clinical and Medical Sciences (TCMS), Volume 2 (2022) Issue 4, 26–31.

Kuntari, T., & Supadmi, S. (2024). Anemia in young pregnant women: A cross-sectional study in Indonesia. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 147–161. https://doi.org/10.20885/JKKI.Vol15.Iss2.art3

Obai, G., Odongo, P., & Wanyama, R. (2016). Prevalence of anaemia and associated risk factors among pregnant women attending antenatal care in Gulu and Hoima Regional Hospitals in Uganda: A cross sectional study. BMC Pregnancy and Childbirth, 16(1), 76. https://doi.org/10.1186/s12884-016-0865-4

Pinho-Pompeu, M., Surita, F. G., Pastore, D. A., Paulino, D. S. M., & Pinto E Silva, J. L. (2017). Anemia in pregnant adolescents: Impact of treatment on perinatal outcomes. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 30(10), 1158–1162. https://doi.org/10.1080/14767058.2016.1205032

Samuel, S., Darebo, T., Desta, D. T., & Mulugeta, A. (2020). Socio-economic and dietary diversity characteristics are associated with anemia among pregnant women attending antenatal care services in public health centers of Kembata Tembaro Zone, Southern Ethiopia. Food Science & Nutrition, 8(4), 1978–1986. https://doi.org/10.1002/fsn3.1485

Sekhar, D. L., Murray-Kolb, L. E., Kunselman, A. R., Weisman, C. S., & Paul, I. M. (2016). Differences in Risk Factors for Anemia Between Adolescent and Adult Women. Journal of Women’s Health, 25(5), 505–513. https://doi.org/10.1089/jwh.2015.5449

Shand, A. W., & Kidson-Gerber, G. L. (2023). Anaemia in pregnancy: A major global health problem. The Lancet, 401(10388), 1550–1551. https://doi.org/10.1016/S0140-6736(23)00396-3

Toteja, G. S., Singh, P., Dhillon, B. S., Saxena, B. N., Ahmed, F. U., Singh, R. P., Prakash, B., Vijayaraghavan, K., Singh, Y., Rauf, A., Sarma, U. C., Gandhi, S., Behl, L., Mukherjee, K., Swami, S. S., Meru, V., Chandra, P., Chandrawati, & Mohan, U. (2006). Prevalence of Anemia among Pregnant Women and Adolescent Girls in 16 Districts of India. Food and Nutrition Bulletin, 27(4), 311–315. https://doi.org/10.1177/156482650602700405

Walsh, N. M., Flynn, A., Walton, J., & Kehoe, L. (2024). Optimal growth and development: Are teenagers getting enough micronutrients from their diet? Proceedings of the Nutrition Society, 83(4), 245–253. https://doi.org/10.1017/S002966512400017X

Wiafe, M. A., Ayenu, J., & Eli-Cophie, D. (2023). A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries. Anemia, 2023, 6406286. https://doi.org/10.1155/2023/6406286

Yılmaz, E., Işıtan, O. Y., Soysal, Ç., Yılmaz, Z. V., Kara, O. F., & Küçüközkan, T. (2018). The influence of anemia on maternal and neonatal outcomes in adolescent pregnant. Journal of Surgery and Medicine, 2(2), Article 2. https://doi.org/10.28982/josam.393143