Impact of obstetric history and pregnancy intervals on postpartum anemia and lactation process: a cross-sectional analysis
Abstract
Background: High Maternal Mortality Rate in Indonesia is linked to postpartum anemia. This study addresses the high prevalence of postpartum anemia (>35%) in Kerek Health Center, Tuban.
Objective: This study aimed to analyze the influence of predictor factors (history of Postpartum Hemorrhage/PPH and pregnancy interval/PI) on Anemia Incidence, as well as the influence of lactation practices (Early Initiation of Breastfeeding/EIBF and history of lactation onset) on Lactation Process.
Methods: A cross-sectional approach was conducted from September 2025 to December 2025. Data analysis was performed using JASP (0.18). The study population comprised all postpartum mothers in the Health Center’s working area, with 200 respondents selected using the total sampling technique. Independent variables included PPH history, PI, EIBF history, and late onset of lactation. The dependent variables were the incidence of anemia and breast milk production.
Results: A significant association was established between a history of PPH and the incidence of anemia (p=0.001), where a history of PPH increased the risk of anemia 5.006 times (OR=5.006). An ideal PI (≥2 years) was identified as a significant and dominant protective factor against anemia (OR=0.297, p=0.001). Regarding the lactation aspect, EIBF history had a significant association (OR=5.631, p=0.001). Conversely, a history of late onset of lactation was also significant to lactation failure (OR=0.165, p=0.001).
Conclusion: Delivery history has a significant influence on the incidence of anemia and the success of lactation. Practically, these findings suggest that healthcare providers should prioritize early screening for high-risk mothers during prenatal care and intensify lactation support programs.
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