The Role of Maternal Stress Epigenetics in the Risk of Stunting among Children Aged 0–24 Months: A Community-Based Longitudinal Study

Juli Purnama Hamudi; Via Zakiah; Harni Harni

doi:10.37899/journallamedihealtico.v7i4.3376

Juli Purnama Hamudi Sekolah Tinggi Ilmu Kesehatan Pelita Ibu, Indonesia
Via Zakiah Sekolah Tinggi Ilmu Kesehatan Pelita Ibu, Indonesia
Harni Sekolah Tinggi Ilmu Kesehatan Pelita Ibu, Indonesia

DOI: https://doi.org/10.37899/journallamedihealtico.v7i4.3376

Keywords: Maternal Stress, Epigenetics, Dna Methylation, IGF2, Stunting

Abstract

Stunting is a major child health problem influenced by multiple factors, including maternal conditions during pregnancy. This study aimed to analyze the relationship between maternal stress, epigenetic mechanisms, and the risk of stunting in children aged 0–24 months. A community-based prospective longitudinal cohort design was employed, involving 30 pregnant women who were followed until their children reached 24 months of age. Maternal stress was assessed using the Perceived Stress Scale (PSS), while epigenetic analysis was conducted via DNA methylation of the IGF2 gene from umbilical cord blood samples. Stunting status was determined based on length-for-age (LAZ) according to WHO standards. The results indicated a tendency toward an increased risk of stunting among mothers with high stress levels (OR=9.00; p>0.05), along with increased IGF2 methylation. Although not statistically significant, the pattern of association was clinically consistent. It is concluded that maternal stress may increase the risk of stunting through epigenetic mechanisms. Integrating stress management into antenatal care is recommended as a strategy for stunting prevention.

References

Adar, O. (2022). Prenatal Depression’s Impact on Newborns and Long-Term Effects on Child Development. Journal of Psychiatry Psychology and Behavioral Research, 3(2), 43–48. https://doi.org/10.21776/ub.jppbr.2022.003.02.10

Allen, R. E., Hochard, K. D., Kannangara, C., & Carson, J. (2024). The Road to Recovery: A Two-Year Longitudinal Analysis of Mental Health Among University Students During and After the COVID-19 Pandemic. Behavioral Sciences, 14(12), 1146. https://doi.org/10.3390/bs14121146

Anjani, A. D., Aulia, D. L. N., Wulandari, N., Berlianti, J. F., Rahniawati, D., Adawiyah, R., & Aulia, N. (2025). Hubungan Stres Pada Ibu Hamil dengan Risiko Kelahiran Prematur. Innovative: Journal of Social Science Research, 5(2), 1732–1741. https://doi.org/10.31004/INNOVATIVE.V5I2.18138

Azmi, B. N., Novianti, H., Oktavia, N. A., & Marani, R. (2025). Hubungan Antara Struktur DNA, Gen, dan Genom dalam Pewarisan Sifat pada Makhluk Hidup. RIGGS: Journal of Artificial Intelligence and Digital Business, 4(4), 4463–4469. https://doi.org/10.31004/riggs.v4i4.4288

Azzahra, D. A., Kurniawati, S. P., Octavianingrum, J. R., & Arini, L. D. D. (2025). Peran Hormon Kortikosteroid dalam Regulasi Metabolisme dan Respons Stres pada Manusia. Nian Tana Sikka: Jurnal Ilmiah Mahasiswa, 3(2), 7–13. https://doi.org/10.59603/niantanasikka.v3i2.733

Batra, P., Kaushik, D., Rasane, P., & Kumar, M. (2026). Early‐Life Protein Nutrition and Enzymatic Regulation: Mechanistic Pathways Linking Growth Faltering, Stunting, and Obesity. The FASEB Journal, 40(7), e71759. https://doi.org/10.1096/fj.202600855R

Bokor, S., Csölle, I., Felső, R., Vass, R. A., Funke, S., Ertl, T., & Molnár, D. (2024). Dietary nutrients during gestation cause obesity and related metabolic changes by altering DNA methylation in the offspring. Frontiers in Endocrinology, 15, 1287255. https://doi.org/10.3389/fendo.2024.1287255

Chang, M. W., Nitzke, S., Brown, R., & Resnicow, K. (2014). A community based prevention of weight gain intervention (Mothers In Motion) among young low-income overweight and obese mothers: design and rationale. BMC public health, 14(1), 280. https://doi.org/10.1186/1471-2458-14-280

Dable-Tupas, G., Maraon, A. B. A., Bernolo, L. J. L., Toñacao, N. G. F., Taylaran, A. D. M., Plata, M. A. C., ... & Gonzales, G. B. (2026). Systems biology insights into the molecular drivers of childhood stunting and implications for intervention. Frontiers in Nutrition, 13, 1761376. https://doi.org/10.3389/fnut.2026.1761376

Ekowati, A. L., William, W., Soeselo, D. A., & Siswanto, F. M. (2025). Identifikasi Peran HSA-MIR-4454 pada Penuaan Kulit: Studi Klinis dan Bioinformatik. Damianus Journal of Medicine, 24(1), 9–17. https://doi.org/10.25170/djm.v24i1.5627

Eskandar, K. (2025). The Genetic Architecture of Behavioral Disorders. Psychotherapie-Wissenschaft, 15(1), 57-63. https://doi.org/10.30820/1664-9583-2025-1-57

Fadhilah, D. A., Rinaldy, A., Sjaaf, F., & Hasni, D. (2020). Prevalensi Efek Samping Kontrasepsi Depo Medroksi Progesteron Asetat Injeksi pada Wanita Usia Subur di Puskesmas Suliki Sumatera Barat. Jurnal Kedokteran Dan Kesehatan, 16(2), 103. https://doi.org/10.24853/jkk.16.2.103-110

Fahmi, K., Badriyah, N., & Kartikaningsih, H. (2025). Sustainability Assessment of Stunting Management through Multidimensional Scaling. The Journal of Indonesia Sustainable Development Planning, 6(3), 496-510. https://doi.org/10.46456/jisdep.v6i3.833

Farhat, Y., Yanti, R., Wirawan, S., Rahman, M. F., Pratiwi, N., & Aprianti. (2025). Stunting pada Balita: Dinamika Determinan Kesehatan dan Konteks Pelayanan Primer. Media Pustaka Indo.

Furuse, Y., Tamaki, R., Suzuki, A., Kamigaki, T., Okamoto, M., Saito-Obata, M., Nakagawa, E., Saito, M., Segubre-Mercado, E., Tallo, V., Lupisan, S., & Oshitani, H. (2021). Epidemiological and Clinical Characteristics of Children with Acute Respiratory Viral Infections in The Philippines: A Prospective Cohort Study. Clinical Microbiology and Infection, 27(7), 1037.e9-1037.e14. https://doi.org/10.1016/j.cmi.2020.09.017

Haloho, A. B., & Legiran. (2023). Mengenal Lebih Dekat Penelitian Kohort: Manfaat Penelitian Kohort pada Bidang Anestesiologi dan Terapi Intensif. Majalah Anestesia & Critical Care, 41(1), 51–57. https://doi.org/10.55497/majanestcricar.v41i1.266

Hermayani, Boseren, S., Maran, P. W. B., & Manik, I. R. U. (2023). Identifikasi Faktor Resiko Secara Konsisten dengan Kejadian Stunting pada Balita. ProHealth Journal, 20(2), 53–63. https://doi.org/10.59802/phj.2023202113

Hidayat, R. (2023). Multidimensional Analysis of Risk Factors for Stunting in Rural South Sumatra, Indonesia: A Community-Based Study. Scientific Journal of Pediatrics, 1(2), 16-28. https://doi.org/10.59345/sjped.v1i1.11

Hiddayaturrahmi, Rosmawaty, Nasitoh, S., Handayani, Y., & Maribeth, A. L. (2024). Faktor-Faktor yang Mempengaruhi Tumbuh Kembang Anak Usia 0-2 Tahun: Tinjauan Literatur. Scientific Journal, 3(4), 221–231. https://doi.org/10.56260/sciena.v3i4.150

Kalinda, C., Qambayot, M. A., Ishimwe, S. M. C., Regnier, D., Bazimya, D., Uwizeyimana, T., ... & Bekele, A. (2024). Leveraging multisectoral approach to understand the determinants of childhood stunting in Rwanda: a systematic review and meta-analysis. Systematic Reviews, 13(1), 16. https://doi.org/10.1186/s13643-023-02438-4

Kamilah, N. (2025). Meninjau Ulang Akses PAUD: Analisis Dialektis Partisipasi Pendidikan Prasekolah Berbasis Data Longitudinal. Aletheia: Jurnal Sosial & Humaniora, Inovasi, Ekonomi, Dan Edukasi, 2(2), 71–83. https://doi.org/10.63892/aletheia.2.2025.71-83

King, S. E., Schatz, N. A., Babenko, O., Ilnytskyy, Y., Kovalchuk, I., & Metz, G. A. (2025). Prenatal maternal stress in rats alters the epigenetic and transcriptomic landscape of the maternal-fetal interface across four generations. Communications Biology, 8(1), 38. https://doi.org/10.1038/s42003-024-07444-3

Lubrano, C., Parisi, F., & Cetin, I. (2024). Impact of maternal environment and inflammation on fetal neurodevelopment. Antioxidants, 13(4), 453. https://doi.org/10.3390/antiox13040453

Maribeth, A. L., Hamda, R., Ariani, O. T., & Yumna, T. R. (2024). Dampak Kehamilan Usia Remaja terhadap Kesehatan Ibu dan Anak: Systematic Review. Nusantara Hasana Journal, 4(1), 50–59. https://doi.org/10.59003/NHJ.V4I1.1144

Maulidina, F. A., Susanti, D., & Kania, S. (2022). Pengalaman Awal Dapat Mengubah Ekspresi Gen dan Mempengaruhi Perkembangan Jangka Panjang. Incrementapedia: Jurnal Pendidikan Anak Usia Dini, 4(1), 42–53. https://doi.org/10.36456/incrementapedia.vol4.no1.a6757

Mulyani, A. T., Khairinisa, M. A., Khatib, A., & Chaerunisaa, A. Y. (2025). Understanding stunting: Impact, causes, and strategy to accelerate stunting reduction—A narrative Review. Nutrients, 17(9), 1493. https://doi.org/10.3390/nu17091493

Nasution, S. M. (2021). Pendekatan Komunitas untuk Membangun Resiliensi di Masa Pandemi Covid-19. IJIP : Indonesian Journal of Islamic Psychology, 3(2), 175–196. https://doi.org/10.18326/IJIP.V3I2.175-196

Pentiernitasari, E., Lina, L., & Yanti, S. N. (2025). Tingkat Emosional Ibu pada Masa Prenatal Mempengaruhi Perkembangan Bayi Pascanatal. Alayya: Jurnal Pendidikan Islam Anak Usia Dini, 5(2), 33–47. https://doi.org/10.51311/ALAYYA.V5I2.1144

Priyono, P. (2020). Strategi Percepatan Penurunan Stunting Perdesaan (Studi Kasus Pendampingan Aksi Cegah Stunting di Desa Banyumundu, Kabupaten Pandeglang). Jurnal Good Governance, 16(2), 1–12. https://doi.org/10.32834/gg.v16i2.198

Ragsdale, H. B. (2023). Developmental Influences on Reproductive Investment: Linking Maternal Nutritional History With Pregnancy Metabolism and Fetal Growth (Doctoral dissertation, Northwestern University).

Rohmawati, W., Wintoro, P. D., Wahyuni, S., & Hartati, L. (2026). Implementasi Pelatihan Keterampilan Dukungan Kesehatan Jiwa Ibu Hamil & Nifas bagi Bidan di Kabupaten Klaten. Involusi: Jurnal Ilmu Kebidanan, 16(1), 1–7. https://doi.org/10.61902/INVOLUSI.V16I1.2233

Sa’adah, H. D., Kurniasih, E., & Komalawati, R. (2024). Edukasi Pentingnya 1000 Hari Pertama Kehidupan dalam Meningkatkan Status Gizi Balita di Dsn. Ngronggi, Ds. Grudo, Kab. Ngawi. Jurnal Pengabdian Kesehatan, 7(2), 467–476. https://doi.org/10.31596/jpk.v7i2.430

Schensul, S. L., Schensul, J. J., Singer, M., Weeks, M., & Brault, M. (2014). Participatory methods and community-based collaborations. Handbook of methods in cultural anthropology, 185.

Setiadi, H., & Dwijayanti, F. (2020). Pentingnya Kesehatan Masyarakat, Edukasi dan Pemberdayaan Perempuan untuk Mengurangi Stunting di Negara Berkembang. Prosiding Seminar Nasional Kesehatan "Peran Tenaga Kesehatan Dalam Menurunkan Kejadian Stunting, 2(01), 16–25. https://doi.org/10.48186/.V2I01.246.16-25

Sumanti, R. (2024). Collaborative Governance: Strategi Pencegahan dan Penurunan Prevalensi Stunting. Jurnal Kebijakan Pembangunan, 19(1), 13–26. https://doi.org/10.47441/jkp.v19i1.361

Wang, Z., & Zhang, J. (2025). Genetic and epigenetic bases of long-term adverse effects of childhood cancer therapy. Nature Reviews Cancer, 25(2), 129-144. https://doi.org/10.1038/s41568-024-00768-6

Wiyono, S., Muntikah, M., & Miranti, M. (2025). Ibu Obesitas Berpengaruh pada Obesitas Anak (Permodelan Pencegahan Dini Obesitas Anak). Jumantik (Jurnal Ilmiah Penelitian Kesehatan), 10(2), 188. https://doi.org/10.30829/jumantik.v10i2.24450

Yusharyahya, S. N. (2021). Mekanisme Penuaan Kulit sebagai Dasar Pencegahan dan Pengobatan Kulit Menua. EJournal Kedokteran Indonesia, 9(2), 150. https://doi.org/10.23886/ejki.9.49.150

Yusriadi, Y., Sugiharti, S., Ginting, Y. M., Sandra, G., & Zarina, A. (2024). Preventing stunting in rural Indonesia: A community-based perspective. African Journal of Food, Agriculture, Nutrition and Development, 24(9), 24470-24491.