Abstract
Introduction: Child stunting remains a major public health concern in Indonesia, driven by multifactorial determinants, including nutritional, socioeconomic, and reproductive factors. Although birth spacing has been hypothesized as an important determinant of child growth, national-level evidence remains limited. Thus, this study examined the association between birth spacing and the risk of stunting among children under five in Indonesia using nationally representative survey data.
Study design: A cross-sectional study.
Methods: Data for this cross-sectional study were obtained from the 2024 Indonesia Nutrition Status Survey, which included 205,406 children aged 0–59 months. Stunting was defined as a height-for-age z-score<−2 SD based on WHO Child Growth Standards. In addition, birth spacings were categorized as<2 years and≥2 years. Complex sample multivariable logistic regression was applied to estimate adjusted odds ratios and 95% confidence intervals (CIs), controlling for child, maternal, and household characteristics.
Results: Among 205,406 children, 18.4% were stunted. Moreover, children born less than two years after their preceding sibling had higher odds of stunting (1.12; 95% CI: 1.08–1.16; P<0.001) compared to those with longer birth spacing after adjusting for child, maternal, and household characteristics.
Conclusion: Short birth spacing was significantly associated with child stunting in Indonesia, providing supportive evidence for considering birth spacing within broader stunting reduction and reproductive health strategies. Accordingly, future longitudinal studies are needed to clarify the causal pathways linking birth spacing and child nutritional outcomes.