Hubungan Antara Ukuran Lingkar Lengan Atas dan Indeks Massa Tubuh dengan Risiko Anemia pada Ibu Hamil  Trimester Awal: The Relationship Between Upper Arm Circumference And Body Mass Index With The Incidence Of Anemia In First Trimester Pregnant Women

Ni Luh Erlya Lionita; Putu Irma Pratiwi; Ni Nyoman Ayu Desy Sekarini

doi:10.35473/jhhs.v8i1.702

Authors

Ni Luh Erlya Lionita Universitas Pendidikan Ganesha
Putu Irma Pratiwi Universitas Pendidikan Ganesha https://orcid.org/0000-0003-2695-581X
Ni Nyoman Ayu Desy Sekarini Universitas Pendidikan Ganesha https://orcid.org/0009-0009-9306-0582

DOI:

https://doi.org/10.35473/jhhs.v8i1.702

Keywords:

anemia, ukuran Lingkar Lengan Atas (LiLA), Indeks Massa Tubuh (IMT), ibu hami pada trimester I, status gizi

Abstract

Anemia in pregnant women remains a public health problem that requires serious attention, especially in the first trimester when physiological changes begin to increase the need for iron. Nutritional status is a major factor associated with anemia in pregnant women. Assessment of nutritional status of pregnant women can be performed using Mid-Upper Arm Circumference (MUAC) and Body Mass Index (BMI). However, data describing the relationship between MUAC and BMI and the incidence of anemia in pregnant women in the first trimester, particularly in midwifery practice, is still limited. Most studies still focus on the later trimester and are conducted in health facilities at the hospital and community health centers (Puskesmas). Therefore, research is needed to support early detection of anemia from early pregnancy. This study was conducted to examine the relationship between MUAC and BMI and the occurrence of anemia in pregnant women in the first trimester. This study applied a quantitative design with a descriptive analytical approach using a cross-sectional method. The population in this study included all pregnant women in the first trimester who visited the TPMB Putu Agustini in Tukadmungga Village, Buleleng Regency in 2025, totaling 91 respondents, with a total sample of 63 respondents determined using a purposive sampling technique. The data used were secondary data sourced from the antenatal care register. The instrument used in this study was an observation sheet or checklist used to record data from the register, including data on LiLA, BMI, and Hb levels of pregnant women. Data analysis was carried out through univariate and bivariate stages using the Fisher's Exact Test. The results of the study showed a significant relationship between LiLA and the occurrence of anemia (p = 0.014). In addition, a significant association was also found between BMI and anemia (p < 0.001). This study concluded that LiLA and BMI showed a significant relationship to anemia in pregnant women in the first trimester.

ABSTRAK

Anemia pada ibu hamil hingga kini masih tergolong sebagai masalah kesehatan masyarakat yang perlu mendapat perhatian serius, terutama pada trimester pertama ketika perubahan fisiologis mulai meningkatkan kebutuhan zat besi. Status gizi berperan sebagai faktor utama yang berkaitan dengan terjadinya anemia pada ibu hamil. Penilaian status gizi ibu hamil dapat dilakukan dengan menggunakan parameter Lingkar Lengan Atas (LiLA) dan Indeks Massa Tubuh (IMT). Namun, data yang menggambarkan hubungan ukuran LiLA dan IMT terhadap kejadian anemia pada ibu hamil trimester I, khususnya pada pelayanan praktik mandiri bidan masih terbatas. Mayoritas studi masih memusatkan perhatian pada trimester lanjut serta dilakukan di fasilitas kesehatan tingkat rumah sakit dan puskesmas. Oleh karena itu, perlu dilakukan penelitian untuk mendukung deteksi dini anemia sejak awal kehamilan. Penelitian ini dilakukan untuk mengkaji hubungan ukuran LiLA dan IMT terhadap terjadinya anemia pada ibu hamil trimester I. Studi ini menerapkan desain kuantitatif dengan pendekatan deskriptif analitik menggunakan metode cross-sectional. Populasi dalam penelitian ini mencakup seluruh ibu hamil trimester I yang melakukan kunjungan ke TPMB Putu Agustini Desa Tukadmungga Kabupaten Buleleng pada tahun 2025 sebanyak 91 responden, dengan total sampel sebanyak 63 responden yang ditentukan melalui teknik purposive sampling. Data yang digunakan berupa data sekunder yang bersumber dari register pelayanan antenatal. Instrument yang digunakan dalam penelitian ini adalah lembar observasi atau checklist yang dipakai untuk mencatat data dari register, meliputi data LiLA, IMT, dan kadar Hb ibu hamil. Analisis data dilakukan melalui tahap univariat dan bivariat dengan menggunakan uji Fisher’s Exact Test. Hasil penelitian menunjukkan adanya hubungan yang bermakna antara LiLA terhadap terjadinya anemia (p = 0,014). Selain itu, ditemukan pula keterkaitan yang signifikan antara IMT terhadap anemia (p < 0,001. Penelitian ini menyimpulkan bahwa LiLA dan IMT menunjukkan hubungan yang signifikan terhadap anemia pada ibu hamil trimester I.

Downloads

Download data is not yet available.

References

Adugna, A., Assefa, N. & Tesfaye, D. (2022) “Association of body mass index with anemia in early pregnancy’, BMC Pregnancy and Childbirth,” BMC Pregnancy and Childbirth, 1(1), pp. 1–10.

Adzkiyah, I., Hafsah and Mulyani, S. (2024) “Asuhan Kebidanan Komprehensif Pada Ny. F Umur 30 Tahun Dengan Kekurangan Energi Kronik Di Puskesmas Kaliwadas Kabupaten Brebes Tahun 2023,” Jurnal Medika Nusantara, 2(3), pp. 1–8. Available at: https://doi.org/https://doi.org/10.59680/medika.v2i3.1143.

Bappeda Provinsi Bali (2023) Laporan Evaluasi Rencana Aksi Daerah Tujuan Pembangunan Berkelanjutan/Sustainable Development Goals.

Brunner, K. et al. (2025) “The Impact of Overweight and Obesity on Pregnancy : A Narrative Review of Physiological Consequences , Risks and Challenges in Prenatal Care , and Early Intervention Strategies,” Current Diabetes Reports, 25(30), pp. 1–12. Available at: https://doi.org/10.1007/s11892-025-01585-3.

Bujani, N.N., Suarniti, N.W. and Cintari, L. (2023) “Hubungan Lingkar Lengan Atas Dan Indeks Massa Tubuh Dengan Kejadian Anemia Pada Ibu Hamil Trimester I di Unit Pelaksana Teknis Dinas Puskesmas Sukawati I Tahun 2021,” Jurnal Ilmiah Kebidanan, 11(1), pp. 25–32.

Dinas Kesehatan Provinsi Bali (2020) Profil Kesehatan Provinsi Bali Tahun 2020.

Dinas Kesehatan Provinsi Bali (2021) Profil Kesehatan Provinsi Bali Tahun 2021.

Fakhriza, I., Ayu, I.G. and Dian, K. (2024) “Hubungan Ukuran Lingkar Lengan Atas Dengan Kejadian Anemia Pada Ibu Hamil Literature Review,” Jember Maternal and Child health Journal, 1(2), pp. 40–45. Available at: https://ojs.poltekkes-malang.ac.id/JMJ/article/view/4939/811.

Fitri, M., Kusumajaya, H. and Megawati (2025) “Faktor-Faktor yang berhubungan dengan kejadian anemia pada ibu hamil di wilayah kerja puskesmas gerunggang kota pangkalpinang tahun 2024,” JUSINDO, 7(2), pp. 2541–7207.

Gebremedhin, S., Ambaw, F., Admasie, A. & Berhane, Y. (2020) “Maternal undernutrition and its association with anemia in pregnancy: evidence from a population-based study,” Gebremedhin, S., Ambaw, F., Admasie, A. & Berhane, Y, 20(1), pp. 1–9.

Hasan, M.M., Khan, M.N., Islam, M.M. & Rahman, M.. (2024) “Low mid-upper arm circumference and its association with anemia among pregnant women in low- and middle-income countries,” BMC Nutrition, 10(1), pp. 1–10.

Hasan, R.T. (2025) “Mid‑upper arm circumference as a tool to assess the nutritional status of pregnant women and associated factors,” Journal of Education and Health Promotion, 14, pp. 1–7. Available at: https://doi.org/10.4103/jehp.jehp_2032_24.

Indrawati, D. (2023) “The Effect of Maternal Anemia and Mid upper Arm Circumference on Low Birth Weight: Meta-Analysis,” The International Conference on Public Health Proceeding, 8(1), p. 51. Available at:

https://theicph.com/index.php/icph/article/view/2581.

Jafarzade, A. et al. (2025) “Anemia levels in the preconception period and the first trimester of pregnancy : a national , multicentric and cross-sectional study,” Rev Bras Ginecol Obstet, pp. 1–6. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11869929/pdf/1806-9339-rbgo-47-e-rbgo1001.pdf.

Kementerian Kesehatan Republik Indonesia (2020) Pedoman pelayanan antenatal terpadu. Kementerian Kesehatan RI.

Kementerian Kesehatan Republik Indonesia (2023) “Survei Kesehatan Indonesia (SKI) 2023 dalam angka.”

Kinyoki, D. et al (2021) “Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018,” Nature Medicine, 27(10), pp. 1761–1782. Available at: https://doi.org/10.1038/s41591-021-01498-0.

Kirat, S. (2024) “The Importance of Micronutrient Deficiency in the Etiology of Anemia in the First Trimester of Pregnancy : a Cross-Sectional Study,” Kafkas J Med Sc, 14(3), pp. 304–310. Available at: https://doi.org/10.5505/kjms.2024.73478.

Lailah, A. and Mudlikah, S. (2025) “Hubungan Indeks Massa Tubuh (IMT ) Dengan Anemia Pada Ibu Hamil Trimester I Di Puskesmas Sekapuk Ujung Pangkah Gresik,” Indonesian Journal of Midwifery, 4(1), pp. 24–32.

Munandar, Y.A. et al. (2025) “Hubungan Lingkar Lengan Atas (LiLA) Ibu Saat Kehamilan Dengan Kejadian Stunting di Wilayah Kerja Puskesmas Sedong Tahun 2022,” Tunas Medika Jurnal Kedokteran & Kesehatan, 11(2), pp. 1–5.

Murray, E.K., Sibley, L.M. & Oliver, J.. (2021) “Body mass index and iron status in pregnancy: exploring the paradox of anemia in overweight and obese women,” Journal of Obstetric, Gynecologic & Neonatal Nursing, 50(5), pp. 625–634.

National Institute of Child Health and Human Development (2023) “About pregnancy.” Available at: https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo?utm_source=chatgpt.com.

Ningsih, S., Lestari, D. & Putri, R.. (2022) “Hubungan lingkar lengan atas dengan kejadian anemia pada ibu hamil,” Jurnal Kesehatan Reproduksi, 13(2), pp. 89–96.

Nuryani et al. (2025) “Faktor-Faktor Yang Berhubungan Dengan Anemia Ibu Hamil Trimester I Di Puskesmas Sungai Siring Samarinda,” Alauddin Scientific Journal of Nursing, 6(1), pp. 78–88. Available at: https://journal.uin-alauddin.ac.id/index.php/asjn/article/view/56214/22423.

Putri, A. and Pasalina, P.E. (2025) “Hubungan Indeks Massa Tubuh Prakehamilan Dan Lingkar Lengan Atas Dengan Kejadian Anemia Pada Ibu Hamil Di Wilayah Kerja Puskesmas Ikur Koto Kota Padang,” Jurnal Kesehatan Saintika Meditory, 8(1), pp. 415–420.

Putri, D.P., Kusyani, A. and Shobirin, G.A. (2023) “Hubungan Status Gizi (LILA) dengan Anemia pada Ibu Hamil,” Jurnal Keperawatan, 21(2), pp. 103–111. Available at: https://ojs.itskesicme.ac.id/index.php/jip/article/view/1235.

Rahmawati, I., Wulandari, R.D. & Sari, N.. (2023) “Lingkar lengan atas sebagai indikator risiko anemia pada ibu hamil di pelayanan kesehatan primer,” Jurnal Kebidanan Indonesia, 14(1), pp. 45–53.

Santos, I.S., Barros, A.J.D., Victora, C.. (2023) “Overweight, obesity and anemia in pregnancy: a multicountry analysis,” Public Health Nutrition, 26(8), pp. 1450–1461.

Satu Data Buleleng (2024) Jumlah Ibu Hamil Anemia Menurut Kecamatan Dan Puskesmas Di Kabupaten Buleleng. Singaraja. Available at: https://satudata.bulelengkab.go.id/.

Sayekti, W.N. (2025) “Anemia Dalam Kehamilan,” in Book Chapter of Anemia. Available at: https://doi.org/https://doi.org/10.5281/zenodo.15893203.

Sugesti, R. and Sansuwito, T. Bin (2025) “Factors Influencing Iron Deficiency Anemia in Pregnant Women : A Systematic Review,” Journal of Health Research and Technology, pp. 145–164.

Tadesse, A., Zeleke, B. & Hailu, D. (2021) “Association between maternal mid-upper arm circumference (MUAC) and nutritional status during pregnancy: evidence from cohort study,” BMC Nutrition, 7(1), pp. 1–8.

Ubom, A.E. et al. (2025) “FIGO good practice recommendations on anemia in pregnancy , to reduce the incidence and impact of postpartum hemorrhage ( PPH ),” International Journal of Gynecology & Obstetrics, 171(3), pp. 993–1007. Available at: https://doi.org/10.1002/ijgo.70529.

WHO (2023a) “Anaemia in women and children: Global Health Observatory (GHO) data.” Availableat:https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children.

WHO (2023b) “WHO recommendations on antenatal care for a positive pregnancy experience,” WHO, Geneva [Preprint].

World Health Organization (2020) “WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations.” Available at: https://www.who.int/publications/i/item/9789240000124.

World Health Organization (2023) “WHO guideline on the prevention and management of anaemia in women of reproductive age,” World Health Organization.