Multifactorial Predictors of Chronic Energy Deficiency (CED) in Pregnant Women: A Literature Review

Authors

  • Dian Refsi Magister Kesehatan Masyarakat, Universitas Mandala Waluya. Kota Kendari, Indonesia
  • Tasnim Tasnim Magister Kesehatan Masyarakat, Universitas Mandala Waluya. Kota Kendari, Indonesia
  • Ari Nofitasari Magister Kesehatan Masyarakat, Universitas Mandala Waluya. Kota Kendari, Indonesia

DOI:

https://doi.org/10.38035/jim.v4i4.1431

Keywords:

Energy Deficiency, Pregnant Women, Risk Factors, Nutrition, Prevention

Abstract

Chronic Energy Deficiency (CED) in pregnant women is a critical public health issue in Indonesia, associated with severe consequences such as maternal anemia, hemorrhage, low birth weight, stunting, and perinatal mortality. This literature review analyzed 15 scientific articles sourced from Google Scholar, PubMed, and ResearchGate, to identify factors associated The analysis identified that CED is influenced by direct factors (inadequate nutritional intake, infectious diseases) and indirect factors (extreme maternal age, low education and knowledge, economic constraints, high parity, short birth intervals, food taboos, and irregular antenatal care). While dominant factors varied regionally, maternal economic status, education, dietary patterns, and pre-pregnancy nutritional status were consistently identified as key determinants. In conclusion effective prevention requires comprehensive, context-specific, and multisectoral strategies, including enhanced nutrition education, strengthening household food security, increasing antenatal care coverage, and promoting optimal birth spacing. These interventions are crucial to reduce CED prevalence and improve maternal and child health outcomes.

References

Adem, H. A., Usso, A. A., Hebo, H. J., Workicho, A., & Ahmed, F. (2023). Determinants of acute undernutrition among pregnant women attending primary healthcare unit in Chinaksen District, Eastern Ethiopia: a case-control study. PeerJ, 11, e15416. https://doi.org/10.7717/peerj.15416

Adesty, R. E. W., Anggadita, T., Damayanti, R., & Mutika, W. T. (2025). Faktor-Faktor yang mempengaruhi Terjadinya Kekurangan Energi Kronis pada Ibu Hamil dengan Risiko Tinggi. Jurnal Kesmas Untika Luwuk?: Public Health Journal, 16(1), 31–39. https://doi.org/10.51888/phj.v16i1.315

Akbarini, O. F., & Siswina, T. (2022). Factors Affecting the Incidence of Chronic Energy Deficiency (CED) in Pregnant Women. Science Midwifery, 10(5), 3776–3783. https://doi.org/10.35335/midwifery.v10i5.841

Alem, A. Z., Efendi, F., McKenna, L., Felipe-Dimog, E. B., Chilot, D., Tonapa, S. I., Susanti, I. A., & Zainuri, A. (2023). Prevalence and factors associated with anemia in women of reproductive age across low- and middle-income countries based on national data. Scientific Reports, 13(1), 20335. https://doi.org/10.1038/s41598-023-46739-z

Andriani, H., Friska, E., Arsyi, M., Sutrisno, A. E., Waits, A., & Rahmawati, N. D. (2023). A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys. BMC Public Health, 23(1), 1836. https://doi.org/10.1186/s12889-023-16728-y

Azevedo, F. M., Morais, N. de S. de, Silva, D. L. F., Candido, A. C., Morais, D. de C., Priore, S. E., & Franceschini, S. do C. C. (2023). Food insecurity and its socioeconomic and health determinants in pregnant women and mothers of children under 2 years of age, during the COVID-19 pandemic: A systematic review and meta-analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1087955

Chilot, D., Belay, D. G., Ferede, T. A., Shitu, K., Asratie, M. H., Ambachew, S., Shibabaw, Y. Y., Geberu, D. M., Deresse, M., & Alem, A. Z. (2023). Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1035759

Dusingizimana, T., Ramilan, T., Weber, J. L., Iversen, P. O., Mugabowindekwe, M., Ahishakiye, J., & Brough, L. (2023). Predictors for achieving adequate antenatal care visits during pregnancy: a cross-sectional study in rural Northwest Rwanda. BMC Pregnancy and Childbirth, 23(1), 69. https://doi.org/10.1186/s12884-023-05384-0

Fauziah, N. A., & Febriyanti, H. (2023). Affecting factors the incidence of chronic energy deficiency (CED) in pregnant women. Jurnal Aisyah?: Jurnal Ilmu Kesehatan, 8(S1), 263–268. https://doi.org/10.30604/jika.v8iS1.1711

González-Fernández, D., Muralidharan, O., Neves, P., & Bhutta, Z. (2024). Associations of Maternal Nutritional Status and Supplementation with Fetal, Newborn, and Infant Outcomes in Low-Income and Middle-Income Settings: An Overview of Reviews. Nutrients, 16(21), 3725. https://doi.org/10.3390/nu16213725

Harna, H., Rahmawati, R., Irawan, A. M. A., & Sa’pang, M. (2024). Prevalence and determinant factors of Chronic Energy Deficiency (CED) in pregnant women. AcTion: Aceh Nutrition Journal, 9(1), 65. https://doi.org/10.30867/action.v9i1.1443

Hasan, M. M., Soares Magalhaes, R., Garnett, S., Fatima, Y., Tariqujjaman, M., Pervin, S., Ahmed, S., & Mamun, A. (2022). Anaemia in women of reproductive age in low- and middle-income countries: progress towards the 2025 global nutrition target. Bulletin of the World Health Organization, 100(03), 196–204. https://doi.org/10.2471/BLT.20.280180

Jenni, S. S. (2025). Factors Associated With The Incidence Of Chronic Energy Deficiency (Ced) In Pregnant Women At The Aek Parombunan Public Health Center, Sibolga City, 2024. Journal of Research and Scientific Assessment, 2(1).

Kumar, P., Srivastava, S., Chaudhary, P., & Muhammad, T. (2023). Factors contributing to socio-economic inequality in utilization of caesarean section delivery among women in Indonesia: Evidence from Demographic and Health Survey. PLOS ONE, 18(9), e0291485. https://doi.org/10.1371/journal.pone.0291485

Kuntari, T., Utami, U., Widyasari, V., Supadmi, S., & Choironi, E. A. (2024). Chronic energy deficiency in young pregnant women in rural Indonesia: an analysis of basic health survey 2018. Jurnal Ners, 19(4), 433–440. https://doi.org/10.20473/jn.v19i4.56196

Laksono, A. D., Wulandari, R. D., Rohmah, N., Rukmini, R., & Tumaji, T. (2023). Regional disparities in hospital utilisation in Indonesia: a cross-sectional analysis data from the 2018 Indonesian Basic Health Survey. BMJ Open, 13(1), e064532. https://doi.org/10.1136/bmjopen-2022-064532

Lassi, Z. S., Padhani, Z. A., Rabbani, A., Rind, F., Salam, R. A., Das, J. K., & Bhutta, Z. A. (2020). Impact of Dietary Interventions during Pregnancy on Maternal, Neonatal, and Child Outcomes in Low- and Middle-Income Countries. Nutrients, 12(2), 531. https://doi.org/10.3390/nu12020531

Leony Lorenza, Usi Lanita, Silvia Mawarti Perdana, Asparian, A., & Sri Astuti Siregar. (2025). Factors Associated with Chronic Energy Deficiency (CED) in Pregnant Women in the Working Area of the Putri Ayu Public Health Center, Jambi City. JURNAL RISET RUMPUN ILMU KEDOKTERAN, 4(1), 61–71. https://doi.org/10.55606/jurrike.v4i1.4428

Marjan, A. Q., Aprilia, A. H., & Fatmawati, I. (2021). Analisis Determinan Faktor yang Berhubungan dengan Kejadian Kurang Energi Kronik (KEK) pada Ibu Hamil di Wilayah Gunung Sindur, Bogor. Jurnal Kesehatan Terpadu (Integrated Health Journal), 12(1), 39–47. https://doi.org/10.32695/jkt.v12i1.117

Mukkadas, H., Salma, W. O., & Cristian Bhinekada, I. M. (2021). Factors Related to Chronic Energy Deficiency in Pregnant Mothers in the Konawe District, Indonesia. Journal of Research Development in Nursing and Midwifery, 18(2), 18–20. https://doi.org/10.52547/jgbfnm.18.2.18

Nofitasari, A., Islaeli, I., & Yusnayanti, C. (2021). Analisis Faktor Determinan dalam Upaya Pencegahan Stunting Anak Usia 2-5 Tahun. Jurnal Aisyah?: Jurnal Ilmu Kesehatan, 6. https://doi.org/10.30604/jika.v6iS1.752

Novelia, S., Rukmaini, & Annisa, E. (2021). Factors Related to Chronic Energy Deficiency among Pregnant Women. Nursing and Health Sciences Journal (NHSJ), 1(3), 237–241. https://doi.org/10.53713/nhs.v1i3.54

Nur’aini, F., Avianty, I., & Noor Prastia, T. (2021). Faktor- Faktor Yang Berhubungan Dengan Kejadian Kurang Energi Kronis (Kek) Pada Ibu Hamil Di Wilayah Kerja Puskesmas Tegal Gundil Bogor Tahun 2020. PROMOTOR, 4(3), 219–226. https://doi.org/10.32832/pro.v4i3.5589

Nuri Luthfiatil Fitri; Senja Atika Sari HS; Nia Risa Dewi; Ludiana; Sri Nurhayati. (2022). The Relationship Of Mother Age With The Event Of Pregnant Mothers In The Work Area Of Ganjar Agung Puskesmas Metro District West Metro City. Jurnal Wacana Kesehatan , 7(1).

Oktavita, D. , H. N. (2023). Faktor Risiko Kekurangan Energi Kronis (Kek) Pada Ibu Hamil Di Puskesmas Gunung Anyar Surabaya. Jurnal Inovasi Kesehatan, 4(3), 583–590.

Owais, A., Merritt, C., Lee, C., & Bhutta, Z. A. (2021). Anemia among Women of Reproductive Age: An Overview of Global Burden, Trends, Determinants, and Drivers of Progress in Low- and Middle-Income Countries. Nutrients, 13(8), 2745. https://doi.org/10.3390/nu13082745

Putra, M. G. S., & Dewi, M. (2020). Faktor Risiko Kurang Energi Kronis (KEK) pada Ibu Hamil di Cikembar Kabupaten Sukabumi. ARTERI?: Jurnal Ilmu Kesehatan, 1(4), 319–332. https://doi.org/10.37148/arteri.v1i4.113

Rita Fauzia, Ester Simanullang, & Retno Wahyuni. (2024). Faktor-Faktor yang Berhubungan Kejadian Kekurangan Energi Kronik pada Ibu Hamil di UPTD Puskesmas Sungai Raya Aceh Timur Tahun 2024. Calory Journal?: Medical Laboratory Journal, 2(3), 195–203. https://doi.org/10.57213/caloryjournal.v2i3.393

Sulistianingrum, L., Octaviana, A., Risneni, R., & Delia Suja, M. D. (2024). Analysis Of Factors Related To The Incident Of Chronic Energy Deficiency (CED) In Pregnant Women. JKM (Jurnal Kebidanan Malahayati), 10(8), 765–770. https://doi.org/10.33024/jkm.v10i8.16928

Wati, E. K., Murwani, R., Kartasurya, M. I., & Sulistiyani, S. (2024). Determinants of chronic energy deficiency (CED) incidence in pregnant women: A cross-sectional study in Banyumas, Indonesia. Narra J, 4(1), e742. https://doi.org/10.52225/narra.v4i1.742

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Published

2025-11-12

How to Cite

Refsi, D., Tasnim, T., & Nofitasari, A. (2025). Multifactorial Predictors of Chronic Energy Deficiency (CED) in Pregnant Women: A Literature Review. Jurnal Ilmu Multidisiplin, 4(4), 2696–2705. https://doi.org/10.38035/jim.v4i4.1431

Issue

Vol. 4 No. 4 (2025): Jurnal Ilmu Multidisplin (Oktober - November 2025)

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Articles

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Copyright (c) 2025 Dian Refsi, Tasnim Tasnim, Ari Nofitasari

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