Pola pertumbuhan anak usia 0-5 tahun di bantul, daerah istimewa yogyakarta
GROWTH PATTERN OF CHILDREN 0-5 YEARS OLD
IN BANTUL SPECIAL REGION YOGYAKARTA
RIZKY CAHYA WINDARI
DEPARTEMEN BIOLOGI
FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM
INSTITUT PERTANIAN BOGOR
BOGOR
2014
ii
PERNYATAAN MENGENAI SKRIPSI DAN SUMBER
INFORMASI SERTA PELIMPAHAN HAK CIPTA
Dengan ini saya menyatakan bahwa skripsi saya berjudul Growth Pattern
of Children 0-5 Years Old in Bantul Special Region Yogyakarta adalah benar
karya saya dengan arahan dari komisi pembimbing dan belum diajukan dalam
bentuk apa pun kepada perguruan tinggi mana pun. Sumber informasi yang
berasal atau dikutip dari karya yang diterbitkan maupun tidak diterbitkan dari
penulis lain telah disebutkan dalam teks dan dicantumkan dalam Daftar Pustaka di
bagian akhir skripsi ini.
Dengan ini saya melimpahkan hak cipta dari karya tulis saya kepada
Institut Pertanian Bogor.
Bogor, Juli 2014
Rizky Cahya Windari
NIM G34100040
iv
ABSTRACT
RIZKY CAHYA WINDARI. Growth Pattern of Children 0-5 Years Old in Bantul
Special Region Yogyakarta. Supervised by BAMBANG SURYOBROTO and
TETRI WIDIYANI.
Growth is one of the phases in the human life cycle. Growth may be defined
as a quantitative increase in size or mass. The aim of this study is to determine the
growth patterns of children 0 – 5 years old in Bantul Special Region Yogyakarta.
The subjects of this research were 320 children 0 – 5 years old who consist of 150
boys and 170 girls. The pattern of growth can be determined by anthropometric
procedures that are measured of body weight, body height/lenght, sitting height,
upper arm circumference and head circumference. Average growth of boys bigger
than girls at every age group. Body weight in boys range between 5.41 kg − 17.29
kg and girls 5.40 kg – 16.73 kg. Body height in boys range between 57.71 cm –
107.5 cm and girls 57.22 cm – 106.2 cm. Sitting height of boys range between
36.77 cm – 57.32 cm and girls only range between only 36.25 cm – 56.30 cm.
Upper arm circumference boys range between 13.79 cm – 16.69 cm and girls
13.67 cm − 16.62 cm. Head circumference boys range between 39.30 cm – 50.27
cm and girls 38.60 cm – 49.73 cm.
Keywords: growth, children, anthropometry, bantul
ABSTRAK
RIZKY CAHYA WINDARI. Pola Pertumbuhan Anak Usia 0-5 tahun di Bantul,
Daerah Istimewa Yogyakarta. Dibimbing oleh BAMBANG SURYOBROTO dan
TETRI WIDIYANI.
Pertumbuhan merupakan salah satu tahapan dalam siklus kehidupan manusia.
Pertumbuhan didefinisikan sebagai peningkatan kuantitatif dalam ukuran atau
massa. Tujuan dari penelitian ini adalah untuk mengetahui pola pertumbuhan anak
usia 0 - 5 tahun di Bantul Daerah Istimewa Yogyakarta. Subyek penelitian ini
adalah 320 anak 0 - 5 tahun yang terdiri dari 150 laki-laki dan 170 perempuan.
Pola pertumbuhan dapat ditentukan dengan prosedur antropometri yang diukur
dari pengukuran berat badan, tinggi badan/panjang badan, tinggi duduk, lingkar
lengan atas dan lingkar kepala. Pertumbuhan rata-rata anak laki-laki lebih besar
daripada perempuan pada setiap kelompok usia. Berat badan pada anak laki-laki
berkisar antara 5,41 kg - 17,29 kg dan anak perempuan 5,40 kg - 16,73 kg. Tinggi
badan anak laki-laki berkisar antara 57,71 cm - 107,5 cm dan anak perempuan
57,22 cm - 106,2 cm. Tinggi duduk anak laki-laki berkisar antara 36.77 cm 57.32 cm, dan anak perempuan 36,25 cm - 56,30 cm. Lingkar lengan atas anak
laki-laki berkisar antara 13,79 cm - 16,69 cm dan anak perempuan 13,67 cm 16.62 cm. Lingkar kepala anak laki-laki berkisar antara 39,30 cm – 50,27 cm dan
anak perempuan 38,60 cm – 49,73 cm.
Kata kunci: pertumbuhan, anak-anak, antropometri, bantul
GROWTH PATTERN OF CHILDREN 0-5 YEARS OLD
IN BANTUL SPECIAL REGION YOGYAKARTA
RIZKY CAHYA WINDARI
Skripsi
sebagai salah satu syarat untuk memperoleh gelar
Sarjana Sains
pada
Departemen Biologi
DEPARTEMEN BIOLOGI
FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM
INSTITUT PERTANIAN BOGOR
BOGOR
2014
vi
Judul Skripsi
Nama
NIM
: Growth Pattern of Children 0-5 Years Old in Bantul Special
Region Yogyakarta
: Rizky Cahya Windari
: G34100040
Disetujui oleh
Dr Bambang Suryobroto
Pembimbing I
Dr Tetri Widiyani SSi MSi
Pembimbing II
Diketahui oleh
Dr Ir Iman Rusmana, M.Si
Ketua Departemen
Tanggal lulus:
viii
FOREWORDS
Praises and thanks to Allah SWT for the blessings and His mercy i can
finishing this study. My research was conducted from Februari until April 2014 in
Bantul with the tiltle is Growth Pattern of Children 0-5 Years Old in Bantul
Special Region Yogyakarta.
Biggest acknowledgements are sending to Dr Bambang Suryobroto as my
first Supervisor and Dr Tetri Widiyani as my second Supervisor for all their the
guidance and advice. I also want to thanked Dr. Dorly, M.Si as an examiner for
examination and suggestion. Writer sending a special acknowledgement to my
family, my lovely mom and brother mas Wawan for all their love and support. Dr
Bambang Suryobroto, Dr Tetri Widiyani, Eneng Nunuz M.Si, Siti Nur Fauziah
S.Si, Nurul Huda S.Si, Arvina S.Si, Sarah Nila MSi. To Vita as my cousins for her
home in bantul, my home mates Dinasti, Novi and Dyka. Thankfull for my
beloved friends Biology 47, Zoo Family, BSH family for the support and the
togetherness. Thanks to my big family in Central Java and East Java, to my
grandfather and grandmother for their prayers. I also want thankfull to instances,
kindergarden, play group, posyandu, hospitals and subject wich belong in this
research. And last, thanks to my daddy. This thesis special for my mom and
daddy.
I hope this research will be usefull for all the readers.
Bogor, Juli 2014
Rizky Cahya Windari
DAFTAR ISI
DAFTAR TABEL
vi
DAFTAR GAMBAR
vi
DAFTAR LAMPIRAN
vi
INTRODUCTION
1
Background
1
Aim
2
MATERIALS AND METHOD
2
Time and Place
2
Sample
2
Informed Consent
3
Measurment
3
Statistical Analysis
3
RESULT
4
Body Weight
4
Body Height
4
Sitting Height
5
Upper Arm Circumference
6
Head Circumference
6
DISCUSSION
7
Body Weight
7
Body Height
8
Sitting Height
8
Upper Arm Circumference
9
Head Circumference
9
CONCLUSION
10
REFERENCES
10
APPENDIXES
12
RIWAYAT HIDUP
18
x
DAFTAR TABEL
1 The number of probands based on age and sex
2 The number of expulsion
2
3
DAFTAR GAMBAR
1
2
3
4
5
Growth pattern in body wight of boys (a) and girls (b)
Growth pattern of body height in boys (a) and girls (b)
Growth pattern of sitting height in boys (a) and girls (b)
Growth pattern of upper arm circumference in boys (a) and girls (b)
Growth pattern of head circumference in boys (a) and girls (b)
4
5
5
6
7
DAFTAR LAMPIRAN
1 The number of probands based on location
2 The questionnaire of proband
3 Comparison of body weigth and body height in boys and girls
between American's child, Bogor's Child, Betawi's child and Bantul
Child
4 Permission of BAPPEDA Bantul
13
14
15
16
1
INTRODUCTION
Background
Growth is one of the phases in the human life cycle. Growth and
development begins from the time of conception to adulthood. Growth may be
defined as a quantitative increase in size or mass, while development is defined as
progession of changes, either quantitative or qualitative, that lead from an
undifferentiated or immature state to highly organized, specialized, and mature
state (Bogin 1999). Growth is influenced by internal factors and external factors.
Internal factor is genetic, hormone, ethnicity or nation, family, age and
chromosomal abnormalities. External factors is environment, social economi and
phsycology (Fox 2002).
Physical measurement of children is required to assess whether the growth
is normal or not. This measurement is important to determine the nutritional status
(Amarita and Veronica 1992), detecting the presence of chronic diseases, and
aberrations in individual growth (Jacob 1981). These assessment need a normal
growth pattern to be used as reference.
The pattern of growth can be determined by anthropometric procedures.
Anthropometry in neonatal and children for assessing nutritional status and
growth that are deemed to be important are measurement of body weight, body
height/lenght, sitting height, upper arm circumference and head circumference.
Suhardjo (1989) explain that a child's weight is a good indicator and overview of
body mass, especially for children under five years old. In this age, body mass is
very sensitive to sudden changes, such as infectious disease, decrease in appetite
or decreasing amount of food consumed (Supariasa & Bakri 2002). Growth of
height is relatively less sensitive than growth of weight in relation to the problem
of malnutrition. Effect of nutrient deficiency on height will only appear in a
relatively long time (Wong 2004). Sitting height is positively correlated with body
mass index in adults, so sitting height can also be used to assess the nutritional
state of children. More over, sitting lenght measurements can also be used to
detect Marfan syndrome and hypochondroplasia syndrome (Bogin and Beydoun
2007). Upper arm circumference tend to increase according to the increase in the
nutritional status of children as well as with increasing age of the child. Head
circumference as an important reflection of growth and development of the brain,
especially in early childhood. Head circumference is also a sensitive
anthropometric indicator of prolonged malnutrition during infancy, so clinicians
use head circumference as a measure of failure to thrive (Bouthoorn 2012). These
anthropometric data are important indicators of the achievement of physical
growth in children (Kuczmarski et al . 2002).
Research on growth patterns of infants and toddlers has been done in Bogor
(Yuliana 2006) and Betawi tribe (Widiastuty 2012). But research on growth
patterns of infants and toddlers in Special Region Yogyakarta has not been done.
2
Aim
The aim of this study is to determine the growth patterns of children 0 – 5
years old in Bantul Special Region Yogyakarta.
MATERIALS AND METHOD
Time and Place
Data was collected during February until April 2014 in Bantul,Yogyakarta.
The sampling was done in four Kindergartens school level, two Integrated
Community Service Post or Pos Pelayanan Terpadu (Posyandu), three Hospitals,
and two by door to door visits (Appendix 1). Data analysis was accomplished in
Section of Biosystematics and Ecology of Animal, Department of Biology, Bogor
Agricultural University.
Sample
The subjects of this research were 320 children 0-5 years old in Bantul
Special Region Yogyakarta. The number of probands based age and sex are
shown in Table 1. Range of age class measured to early birthday. The children in
0 years old is 0 – 6 months, 1 year old is 7 months – 1.5 years old, 2 years old is
1.6 years old – 2.5 years old, 3 years old is 2.6 years old – 3.5 years old, 4 years
old is 3.6 years old – 4.5 years old, and 5 years old is 4.6 years old – 5.5 years old.
Table 1. The number of probands based on age and sex
Age
(years)
0
1
2
3
4
5
Number
Percent(%)
boys
girls
Number
11
15
17
32
40
35
150
46.8
20
16
20
24
42
48
170
53.2
31
31
37
56
82
83
320
100
Probandus in this study had a low socio-economic backgrounds. It is known
from the results of questionnaire (Appendix 2), where the average of expenditure
per month for a family meal ranges between Rp. 750.000 - Rp 1.000.000 from 284
probands who known (Table 2). Average of expulsion is lower than the value of
Wages of Minimum Regional (UMR) in Bantul. Based on decision of the
Governor D.I Yogyakarta Decree. 279/2013 on the Wages of Minimum Regional
(UMR) Bantul in 2014, mentions a large UMR Bantul is Rp. 1.125.500 (Pemda
D.I Yogyakarta 2013).
3
Table 2. The number of expulsion
Expulsion
(Rupiah)
< 500.000
500.00 – 750.000
750.000 – 1.000.000
1.000.000 – 1.250.000
1.250.000 – 1.500.000
>1.500.000
unknown
Number of
Probands
24
57
63
45
42
53
36
Percent (%)
7.5
17.8
19.2
14
13.2
16.6
11.25
Informed Consent
The parents or guardians of children were given detailed information and
they signed the informed consent and completed questionnaires if they agree to
participate.
Measurement
Growth pattern was calculated based on five antrophometric dimensions;
that are, body weight, body height, sitting height, upper arm circumference, and
head circumference.
Body weight was measured by putting baby lying on the baby scale. For
toddlers, body weight was measured using digital weight scale of Uchida.
Proband standing calmly and look straight ahead.
Lenght of baby was measured using measuring board. Proband was placed
in the supine position on a measurements board. They view straight up, their head
hit on the boards. Body and legs of proband were placed horizontal, heel
straightened. For toodlers, body height was measured using stadiometer. Proband
stand upright and relaxed, look straight ahead, heels and knees straightened.
Sitting height was measured as the length from head to rump using
measuring tape. Upper Arm circumference was measured using measuring tape at
the proband’s upper left arm, between the shoulder and elbow, wrapped around
not tensioned. Head circumference was measured using measuring tape. Wrapped
tape around the baby’s head in the part of largest. This is above the eyebrows and
the tops of the ears.
Statistical Analysis
Growth pattern of boys and gils presented by 3rd, 5th, 10th, 25th, 50th, 75th,
90th, 95th, and 97th percentiles at each age group. Generalized additive models for
location scale and shape (GAMLSS) used for determined percentile
(Stasinopoulus and Rigby 2005) and implemented in R program version 2.15.2
(Development Core Team 2012).
4
RESULTS
Body Weight
Growth pattern of body weigt in boys and girls are shown in Figure 1.
Growth pattern of body weigth boys is bigger than girls. Mean of 0 year old in
boys is 5.41 kg and in girls is 5.48 kg. Mean of 1 year old in boys is 9.52 kg and
girls is 8.17 kg. Mean of 2 years old in boys is 10.52 kg and girls is 10.68 kg.
Mean of 3 years in boys is 14.01 kg and girls is 13.00 kg. Mean of 4 years old in
boys is 15.69 kg and girls is 14.40 kg. Mean of 5 years old in boys is 17.29 kg and
girls is 16.73 kg.
%97
%95
girls
25
25
boys
%90
%75
20
20
%97
%95
%90
%75
%50
%25
5
10
15
%10
%5
%3
0
5
10
15
%10
%5
%3
body weight (kg)
%25
0
body weight (kg)
%50
0
1
2
3
4
age(year)
5
6
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 1. Growth pattern in body wight of boys (a) and girls (b)
Body Heigth
Growth pattern of body heigth in boys and girls are shown in Figure 2.
Mean of body height in boys is higher than mean body height in girls. Mean of 0
years in boys is 57.71 cm and in girls is 57.22 cm. Mean of 1 years in boys is
74.33 cm and in girls 72.31 cm. Mean of 2 years old in boys is 83.98 cm and girls
is 83.82 cm. Mean of 3 years in boys is 94.04 cm and girls is 91.71 cm. Mean of 4
years old in boys is 101.70 cm and girls is 99.19 cm. Mean of 5 years old in boys
is 107.5 and girls is 106.2 cm.
5
girls
120
120
boys
%97
%95
%90
%97
%95
%90
%75
%50
110
110
%75
%50
90
80
70
50
60
body height (cm)
100
90
80
70
60
40
50
30
40
30
0
1
2
3
4
5
0
6
1
2
3
4
5
6
age(year)
age(year)
(a)
(b)
Figure 2. Growth pattern of body height in boys (a) and girls (b)
Sitting Height
70
70
Growth pattern of sitting heigth in boys and girls are shown in Figure 3.
Mean of sitting height in boys higher than mean body height’s girls. Mean of 0
years in boys is 36.77 cm and in girls is 36.25 cm. Mean of 1 years in boys is
44.43 cm and in girls 42.64 cm. Mean of 2 years old in boys is 46.79 cm and girls
is 46.00 cm. Mean of 3 years in boys is 52.18 cm and girls is 50.61 cm. Mean of 4
years old in boys is 54.66 cm and girls is 53.68 cm. Mean of 5 years old in boys is
57.32 and girls is 56.30 cm
boys
girls
%97
%95
%97
%95
%90
%75
%90
60
%50
%25
40
50
%10
%5
%3
30
30
40
50
%50
%25
%10
%5
%3
Sitting height (cm)
60
%75
Sitting height (cm)
body height (cm)
%25
%10
%5
%3
100
%25
%10
%5
%3
0
1
2
3
4
age(year)
5
6
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 3. Growth pattern of sitting height in boys (a) and girls (b)
6
Upper Arm Circumference
Growth Pattern of upper arm circumference in boys and girls are shown in
Figure 4. Mean of upper arm circumference in boys is bigger than girls. Mean of 0
years in boys is 13.73 cm and in girls is 13.67 cm. Mean of 1 years in boys is
15.01 cm and in girls 14.42 cm. Mean of 2 years old in boys is 15.08 cm and girls
is 14.52 cm. Mean of 3 years in boys is 16.17 cm and girls is 16.12 cm. Mean of 4
years old in boys is 16.26 cm and girls is 16.18 cm. Mean of 5 years old in boys is
16.69 cm and girls is 16.62 cm.
girls
%90
%75
%50
%25
20
%75
%50
%25
%10
%5
%3
10
15
%10
%5
%3
%90
15
%97
%95
Upper Arm Circumference (cm)
20
%97
%95
10
Upper Arm Circumference (cm)
boys
0
1
2
3
4
age(year)
5
6
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 4. Growth Pattern of upper arm circumference of boys (a) and girls (b)
Head Circumference
Growth pattern of head circumference in boys and girls are shown in Figure
5. Mean of Head Circumference in boys is higher than girls. Mean of 0 years in
boys is 39.30 cm and in girls is 38.60 cm. Mean of 1 years in boys is 45.12 cm
and in girls 44.56 cm. Mean of 2 years old in boys is 47.19 cm and girls is 46.74
cm. Mean of 3 years in boys is 48.81 cm and girls is 48.12 cm. Mean of 4 years
old in boys is 49.70 cm and girls is 48.52 cm. Mean of 5 years old in boys is 50.27
cm and girls is 49.73 cm.
7
55
girls
50
%50
%25
40
45
%10
%5
%3
30
30
35
40
45
%25
%10
%5
%3
Head Circumference (cm)
50
%50
%97
%95
%90
%75
%97
%95
%90
%75
35
Head Circumference (cm)
55
boys
0
1
2
3
4
5
6
age(year)
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 5. Growth pattern of head circumference in boys (a) and girls (b)
DISCUSSION
Body Weight
Anthropometric data are valuable objective indicators of attained size and
physical growth in children. Body weight and body height are the mostly
anthropometric data that use to determinate nutritional status of children.
Malnutrition more influence to body weight than body height (Khomsan 2004).
Up to five years old, children’s weight gain significantly. Body mass is very
sensitive to sudden changes, such as infectious disease, decreased appetite or
decreasing the amount of food consumed (Supariasa & Bakri 2002). The pattern
of body weight curves indicates that body mass increases rapidly from birth to
approximately 5 years old. Body weight gain on average 2 − 4 kg every year
during preschool age.
Body weight in boys 0 - 5 years old in Bantul old is bigger than body weight
in girls at each age group. This is because boy have a muscle mass, body mass and
metabolic rate greater than girls (Watson and Lowrey 1951). Body weight in boys
vary for each age which range between 5.41 kg − 17.29 kg, while girls only range
between 5.40 kg − 16.73 kg.
Growth curves are an essential tool in pediatric practice. Their value resides
in helping to determine the degree to which physiological needs for growth and
development are being met during the important childhood period. However, their
usefulness goes far beyond assessing children’s nutritional status (De Onis 2009).
The growth curve of body weight boys and girls showed probandus in under
0.03 percentiles were having body weight smaller in their age group. Some
8
proband in 0.90 percentiles to 0.97 percentiles were having overweight and
proband in above 0.97 percentiles were having obesity in their each age group.
Generally, the child's body weight in Bantul is lower than American
children (De Onis et al. 2006), Bogor children (Yuliana 2006) and Betawi
children (Widiastuty 2013) (Appendix 3). This is probably because the socioeconomic conditions in Bantul was lower than America, Bogor and Betawi tribe.
therefore , it has enviromental, and genetic is different also.
Body Height
The growth pattern of body height much affected by the condition of
malnutrition in the short term. But if prolonged nutritional deficiency and severe,
then the growth pattern of body height can be affected even interfere with the
maturation process. Body height can be inhibited by a protein deficiency despite
sufficient intake energy. The fastest height growth occurs during puberty along
with sexual maturity. Added height and weight along with increasing proportions
of the body (Khomsan 2004).
Body height anthropometric describes the state of skeletal growth. In normal
condition, body height grows with age. Body Height growth unlike weight, its
relatively less sensitive to the problem of malnutrition in a short time. Effect of
nutrient deficiency on height will appear in a relatively long time (Wong 2004).
The pattern of body height curves indicate that body height increases rapidly
from birth to approximately 3 years old. Body height gain average in 0 − 3 years
old is 9 − 16 cm and in 4 − 5 years old average 5 − 8 cm. Body weight in boys 0 5 years old in Bantul is bigger than body weight in girls. Body height in boys
vary for each age which range between 57.71 cm − 107.5 cm, while girls only
range between 57.22 cm − 106.2 cm.
Somatotropin or Growth Hormone (GH) is a major regulator of the growth
framework. Added height is strongly influenced by this hormone. GH stimulates
the formation of somatomedin which then affects the cartilage (Soetjiningsih
1995).
Body height is obtaine similar results with body weight, in which the child's
body height in Bantul is also lower than body height of America children (De
Onis et al. 2006), Bogor children (Yuliana 2006), and Betawi tribe children
(Widiastuty 2013) (Appendix 3).
Sitting Height
Sitting height is correlate positive with body mass index values of children,
therefore, sitting height can also used to assess the nutritional state of children.
Length measurements can also be done seated to detect Marfan syndrome and
Hipokondroplasia syndrome (Bogin & Beydoun 2007). Marfan syndrome (MFS)
is an autosomal dominant connective tissue disorder involving the cardiovascular,
skeletal and ocular systems, the integument, lungs and dura. Cardinal
manifestations include aortic aneurysm and dissection, ocular lens dislocation and
long bone overgrowth. In 90-93% of cases, MFS is caused by mutations in FBN1
(Loeys 2010). Hypochondroplasia is a skeletal dysplasia characterized by short
stature, stocky build, disproportionately short arms and legs, and broad short
9
hands and foot. Hypochondroplasia is a genetic disorder with mostly caused by
mutations in FGFR3 gene (Matsui et al. 1998).
Widiastuty (2012) reported that, can adjust the length of sitting height. If a
child has a higher height , then a child has sitting height longer also.
The pattern of sitting height curves indicates that sitting height increases
rapidly from birth to approximately 3 years old. Body height gain average in 0 − 3
years old is 5 − 7 cm and in 4 − 5 years old gain average 2 cm. Sitting height of
boys vary for each age 0 to 5 years which range between 36.77 cm − 57.32 cm,
while girls only range between 36.25 cm − 56.30 cm.
Upper Arm Circumference
Upper arm circumference is a reflection of the growth and development of
fat tissue and muscle. Upper arm circumference was used to assess nutrition or
growth and development in the preschool age group (Sulistyawati 2014).
The results showed that Upper arm circumference boys is bigger than girls.
Upper arm circumference boys 0 to 5 years old range between 13.79 cm − 16.69
cm and while girls only range between 13.67 cm − 16.62 cm. Upper arm
circumference gain on average 2 cm every year.
Head Circumference
The aim of head circumference measurment for determine childs's head
circumference within the normal range or not. (Bouthoorn et all. 2012) reported
that, several studies recognized head circumference (HC) as an important
reflection of growth and development of the brain, especially in early childhood.
HC is also a sensitive anthropometric indicator of prolonged malnutrition during
infancy, so clinicians use HC as a measure of failure to thrive.
Growth of head circumference associated with brain development. The most
critical period and rapid of brain development is from the fetus in gestation period
until after birth to 2 years old. Brain development is related to the multiplication
and increase size of brain cells quickly. Size cells only increase after 2 years old
(Khomsan 2004).
The pattern of head circumference curves indicates that head circumference
increases rapidly from birth to approximately 2 years old and gain sicnificantly on
average 8 cm. Head circumference boys vary for each age 0 to 5 years old which
range between 39.30 cm − 50.27 cm, while girls only range between 38.60 cm −
49.73 cm.
Brain growth is closely related to malnutrition. Therefore, measure of head
circumference is often used as an indicator to determine nutritional status of child
indicators. Head circumference measurements are sensitive only to a certain age
where brain development is going on. At preschool age, children with
malnutrition have smaller head circumferences than normal children (Khomsan
2004).
10
CONCLUSION
The growth pattern of children 0 − 5 years old in Bantul Special Region
Yogyakarta, showed a similiar pattern in body weight, body height, sitting height,
upper arm circumference and head circumference, which is likely increase.
Average growth of boys bigger than girls at every age group.
REFERENCES
Almarita, Veronica L. 1992. Penggunaan indeks massa tubuh (Body Mess Index)
sebagai indikator status gizi orang dewasa. Gizi Indonesia 17 (1) : 50 – 56.
Bogin B , Beydoun N. 2007. The relationship of sitting height ratio to body mass
index and fatness in the United States 1988-1999. Human Ecology 15: 1-8.
Bouthoorn SH, Van Lenthe FJ, Koelega A, Moll AH, Tiemeier H, Hofman A,
Mackenbach JP, Jaddoe V, Raat H. 2012. Head Circumference of Infants
Born to Mothers with Different Educational Levels; The Generation R
Study. PLoS ONE . 7(6): e39798. doi:10.1371/journal.pone.0039798.
De Onis, Mercedes. 2009. Growth Curves for School-age Children and
Adolescents. Indian Pediatric. 46 : 463 – 465.
De Onis et al. 2006. WHO child growth standards : length/height-for-age, weightfor-age, weight-for-length, weight-forheight and body mass index-for-age :
methods and development. Switzerland (FR) : WHO Press.
Fox SI. 2002. Human Physiology. Ed ke-7. New York (US) : McGraw-Hill.
Jacob T. 1981. Norma Pertumbuhan Untuk Indonesia. Berkala ilmu kedokteran
Gajah Mada Jilid 13. Cetak ulang dalam Indriati E, Editor. 2002.
Antropometri Biologis. Jakarta (ID) : Direktorat Jenderal Pendidikan Tinggi
Departemen Pendidikan Nasional.
Khomsan, A. 2004. Pangan dan gizi untuk kesehatan. Jakarta (ID) : PT. Raja
Grafindo Persada.
Loeys BL et al. 2010. The revised Ghent nosology for the Marfan syndrome. J
Med Genet. 47: 476-485.
Matsui Y, Yasui, Kimura T, Tsumaki, Kawabata, Ochi. Genotype and phenotype
correlation in achondroplasia and hipokondroplasia. 1998. Journal Bone
Joint Surgery. 88: 1052-1057
Pemerintah Daerah D.I Yogyakarta. 2013. Peraturan Gubernur Provinsi Daerah
Istimewa Yogyakarta No. 279/2013 tentang Upah Minimum Provinsi Tahun
2013.
R Development Core Team. 2012. R: A Language and Environment for Statistical
Computing. R Fondation for Statistical Computing, Vienna, Austria. ISBN
3-900051-07-0. http://www.rproject.org/.
Soetjiningsih. 1995. Tumbuh Kembang Anak. Jakarta (ID) : Penerbit Buku
Kedokteran EGC.
Stasinopoulos DM, Rigby RA. 2005. Generalized additive models for location
scale and shape (GAMLSS) in R. Journal Statistics Software. 55:1-64.
Supariasa B, Bakri I F. 2002. Penilaian Status Gizi. Jakarta (ID): Penerbit Buku
Kedokteran EGC.
11
Watson EH, Lowrey GH. 1951. Growth and Development of Children. Ed ke-2.
USA (US) : Year Book.
Widiastuty, H. 2013. Pola Pertumbuhan Anak Usia 1–5 Tahun di Perkampungan
Budaya Betawi Setu Babakan, Jakarta Selatan [Skripsi]. Bogor (ID) :
Fakultas Matematika dan Ilmu Pengetahuan Alam, Institut Pertanian Bogor.
Wong. 2004. Pedoman Klinis Keperawatan Pediatrik. Edisi 4. Jakarta (ID):
Penerbit Buku Kedokteran EGC.
Yuliana. 2006. Pola pertumbuhan Anak Usia 1-5 Tahun di kota Bogor [Skripsi].
Bogor (ID) : Fakultas Matematika dan Ilmu Pengetahuan Alam. Institut
Pertanian Bogor.
12
APPENDIX
13
Appendix 1. The number of probands based on location
Sex
Location
Boys
Girls
Posyandu Kemuning Kec. Kasihan
12
15
Posyandu Prancak Dukuh Kec. Sewon
22
15
RS. PKU Muhammadiyah Bantul
4
5
RS. Panembahan Senopati Bantul
20
32
RS. Ibu Anak Ummi Khasannah
1
4
TK. Aisyiyah Bustanul Alfath Krapyak Wetan
22
27
TK. Kuncup Harapan Sewon
12
23
TK. Taat Insan Mulia Kec. Kasihan
44
37
PAUD. Raudhatul Kec. Sewon
13
10
-
2
150
170
Door to door
Number
14
Appendix 2. The questionnaire of probands
KUISIONER PENELITIAN
Tanggal
ID num
:
:
Data Pribadi
Nama Lengkap
Jenis Kelamin
Alamat (kampung)
:
: P/L
:
Kelurahan :
Tempat Lahir (kampung) :
Tanggal Lahir
:
Usia
:
tahun
Anak ke:
dari
bersaudara
Penyakit (jika ada)
:
Pemberian ASI sampai usia :
Umur berapa mulai non ASI (makan) :
Frekuensi makan per hari :
Pengeluaran perbulan
:
Tinggal di bantul sejak (tanggal/bulan/tahun/) :
Kecamatan :
Data Orang Tua
Nama Ayah
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ibu
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ayah dari Ayah
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ayah dari Ibu
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ibu dari Ayah
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ibu dari Ibu
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Pendapatan keluarga per bulan untuk makan (pilih salah satu) :
1. X < Rp. 500.000
4. Rp. 1.000.000 ≤ X < Rp. 1.250.000
2. Rp. 500.000 ≤ X < Rp. 750.000
5. Rp. 1.250.000 ≤ X < Rp. 1.500.000
3. Rp. 750.000 ≤ X < Rp. 1.000.000
6. Rp. X ≥ Rp. 1.500.000
Ket : X = Total pengeluaran keluarga per bulan untuk makan
Data Pengukuran
No
1
2
3
4
5
Parameter
Berat Badan
Tinggi Badan
Panjang Duduk
Lingkar Lengan
Lingkar Kepala
Tempat pengukuran :
Kode
BB
TB
PD
LL
LK
Hasil Pengukuran
15
Appendix 3. Comparison of body weigth and body height in boys and girls
between American’s child, Bogor’s child, Betawi’s child and
Bantul’s child
Comparison in body weight of 50th percentile
Age
America
Bogor Children Betawi Children Bantul Children
(year)
Children
B
G
B
G
B
G
B
G
1 10.9
10.0
9.6
9.0
8.5
8.2
9.5
8.1
2 13.3
12.7
11.4
10.5
11.3
10.1
10.5
10.6
3 15.3
14.6
13.9
12.5
13.8
11.9
14.0
13.0
4 17.3
17.0
16.0
15.3
15.8
13.8
15.6
14.4
5 18.3
18.2
19.3
17.8
17.9
16.0
17.2
16.7
Comparison in body height of 50th percentile
Age
(year)
1
2
3
4
5
America
Children
B
82.3
91.9
99.2
106.7
110.0
B : boys
G : girls
Bogor Children
G
80.7
90.7
99.0
105.6
109.4
B
77.2
88.6
92.6
102.1
111.0
G
74.7
86.6
93.7
101.3
108.9
Betawi Children Bantul Children
B
74.0
87.9
91.3
101.5
109.8
G
72.5
84.6
92.8
99.5
106.1
B
74.3
83.9
94.0
101.7
107.5
G
72.3
83.8
91.7
99.1
106.2
16
Appendix 4. Permission of BAPPEDA Bantul
17
18
RIWAYAT HIDUP
Penulis dilahirkan di Biak pada tanggal 24 Agustus 1992 dari ayah Suyanto
(Alm) dan ibu Rossiyem. Penulis adalah anak kedua dari dua bersaudara. Tahun
2010 penulis menyelesaikan pendidikan di SMAN 1 Biak Kota dan pada tahun
yang sama penulis melanjutkan studi pada Jurusan Biologi, Fakultas Matematika
dan Ilmu Pengetahuan Alam, Institut Pertanian Bogor melalui jalur USMI.
Selama mengikuti perkuliahan, penulis aktif sebagai bendahara di Divisi
Infokom HIMABIO sebagai bendahara pada tahun 2012/2013 dan pada tahun
2013/2014 penulis menjadi asisten praktikum Fisiologi Prokariot.
Penulis melakukan Studi Lapangan dengan judul Invertarisasi Fauna Air di
Taman Nasional Gunung Pangrango pada tahun 2012 dan melakukan Praktik
Lapangan dengan judul Perawatan dan pengamatan tingkah laku Snow Leopard
(Panthera uncia) di Taman Safari Indonesia Cisarua – Bogor pada tahun 2013.
19
IN BANTUL SPECIAL REGION YOGYAKARTA
RIZKY CAHYA WINDARI
DEPARTEMEN BIOLOGI
FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM
INSTITUT PERTANIAN BOGOR
BOGOR
2014
ii
PERNYATAAN MENGENAI SKRIPSI DAN SUMBER
INFORMASI SERTA PELIMPAHAN HAK CIPTA
Dengan ini saya menyatakan bahwa skripsi saya berjudul Growth Pattern
of Children 0-5 Years Old in Bantul Special Region Yogyakarta adalah benar
karya saya dengan arahan dari komisi pembimbing dan belum diajukan dalam
bentuk apa pun kepada perguruan tinggi mana pun. Sumber informasi yang
berasal atau dikutip dari karya yang diterbitkan maupun tidak diterbitkan dari
penulis lain telah disebutkan dalam teks dan dicantumkan dalam Daftar Pustaka di
bagian akhir skripsi ini.
Dengan ini saya melimpahkan hak cipta dari karya tulis saya kepada
Institut Pertanian Bogor.
Bogor, Juli 2014
Rizky Cahya Windari
NIM G34100040
iv
ABSTRACT
RIZKY CAHYA WINDARI. Growth Pattern of Children 0-5 Years Old in Bantul
Special Region Yogyakarta. Supervised by BAMBANG SURYOBROTO and
TETRI WIDIYANI.
Growth is one of the phases in the human life cycle. Growth may be defined
as a quantitative increase in size or mass. The aim of this study is to determine the
growth patterns of children 0 – 5 years old in Bantul Special Region Yogyakarta.
The subjects of this research were 320 children 0 – 5 years old who consist of 150
boys and 170 girls. The pattern of growth can be determined by anthropometric
procedures that are measured of body weight, body height/lenght, sitting height,
upper arm circumference and head circumference. Average growth of boys bigger
than girls at every age group. Body weight in boys range between 5.41 kg − 17.29
kg and girls 5.40 kg – 16.73 kg. Body height in boys range between 57.71 cm –
107.5 cm and girls 57.22 cm – 106.2 cm. Sitting height of boys range between
36.77 cm – 57.32 cm and girls only range between only 36.25 cm – 56.30 cm.
Upper arm circumference boys range between 13.79 cm – 16.69 cm and girls
13.67 cm − 16.62 cm. Head circumference boys range between 39.30 cm – 50.27
cm and girls 38.60 cm – 49.73 cm.
Keywords: growth, children, anthropometry, bantul
ABSTRAK
RIZKY CAHYA WINDARI. Pola Pertumbuhan Anak Usia 0-5 tahun di Bantul,
Daerah Istimewa Yogyakarta. Dibimbing oleh BAMBANG SURYOBROTO dan
TETRI WIDIYANI.
Pertumbuhan merupakan salah satu tahapan dalam siklus kehidupan manusia.
Pertumbuhan didefinisikan sebagai peningkatan kuantitatif dalam ukuran atau
massa. Tujuan dari penelitian ini adalah untuk mengetahui pola pertumbuhan anak
usia 0 - 5 tahun di Bantul Daerah Istimewa Yogyakarta. Subyek penelitian ini
adalah 320 anak 0 - 5 tahun yang terdiri dari 150 laki-laki dan 170 perempuan.
Pola pertumbuhan dapat ditentukan dengan prosedur antropometri yang diukur
dari pengukuran berat badan, tinggi badan/panjang badan, tinggi duduk, lingkar
lengan atas dan lingkar kepala. Pertumbuhan rata-rata anak laki-laki lebih besar
daripada perempuan pada setiap kelompok usia. Berat badan pada anak laki-laki
berkisar antara 5,41 kg - 17,29 kg dan anak perempuan 5,40 kg - 16,73 kg. Tinggi
badan anak laki-laki berkisar antara 57,71 cm - 107,5 cm dan anak perempuan
57,22 cm - 106,2 cm. Tinggi duduk anak laki-laki berkisar antara 36.77 cm 57.32 cm, dan anak perempuan 36,25 cm - 56,30 cm. Lingkar lengan atas anak
laki-laki berkisar antara 13,79 cm - 16,69 cm dan anak perempuan 13,67 cm 16.62 cm. Lingkar kepala anak laki-laki berkisar antara 39,30 cm – 50,27 cm dan
anak perempuan 38,60 cm – 49,73 cm.
Kata kunci: pertumbuhan, anak-anak, antropometri, bantul
GROWTH PATTERN OF CHILDREN 0-5 YEARS OLD
IN BANTUL SPECIAL REGION YOGYAKARTA
RIZKY CAHYA WINDARI
Skripsi
sebagai salah satu syarat untuk memperoleh gelar
Sarjana Sains
pada
Departemen Biologi
DEPARTEMEN BIOLOGI
FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM
INSTITUT PERTANIAN BOGOR
BOGOR
2014
vi
Judul Skripsi
Nama
NIM
: Growth Pattern of Children 0-5 Years Old in Bantul Special
Region Yogyakarta
: Rizky Cahya Windari
: G34100040
Disetujui oleh
Dr Bambang Suryobroto
Pembimbing I
Dr Tetri Widiyani SSi MSi
Pembimbing II
Diketahui oleh
Dr Ir Iman Rusmana, M.Si
Ketua Departemen
Tanggal lulus:
viii
FOREWORDS
Praises and thanks to Allah SWT for the blessings and His mercy i can
finishing this study. My research was conducted from Februari until April 2014 in
Bantul with the tiltle is Growth Pattern of Children 0-5 Years Old in Bantul
Special Region Yogyakarta.
Biggest acknowledgements are sending to Dr Bambang Suryobroto as my
first Supervisor and Dr Tetri Widiyani as my second Supervisor for all their the
guidance and advice. I also want to thanked Dr. Dorly, M.Si as an examiner for
examination and suggestion. Writer sending a special acknowledgement to my
family, my lovely mom and brother mas Wawan for all their love and support. Dr
Bambang Suryobroto, Dr Tetri Widiyani, Eneng Nunuz M.Si, Siti Nur Fauziah
S.Si, Nurul Huda S.Si, Arvina S.Si, Sarah Nila MSi. To Vita as my cousins for her
home in bantul, my home mates Dinasti, Novi and Dyka. Thankfull for my
beloved friends Biology 47, Zoo Family, BSH family for the support and the
togetherness. Thanks to my big family in Central Java and East Java, to my
grandfather and grandmother for their prayers. I also want thankfull to instances,
kindergarden, play group, posyandu, hospitals and subject wich belong in this
research. And last, thanks to my daddy. This thesis special for my mom and
daddy.
I hope this research will be usefull for all the readers.
Bogor, Juli 2014
Rizky Cahya Windari
DAFTAR ISI
DAFTAR TABEL
vi
DAFTAR GAMBAR
vi
DAFTAR LAMPIRAN
vi
INTRODUCTION
1
Background
1
Aim
2
MATERIALS AND METHOD
2
Time and Place
2
Sample
2
Informed Consent
3
Measurment
3
Statistical Analysis
3
RESULT
4
Body Weight
4
Body Height
4
Sitting Height
5
Upper Arm Circumference
6
Head Circumference
6
DISCUSSION
7
Body Weight
7
Body Height
8
Sitting Height
8
Upper Arm Circumference
9
Head Circumference
9
CONCLUSION
10
REFERENCES
10
APPENDIXES
12
RIWAYAT HIDUP
18
x
DAFTAR TABEL
1 The number of probands based on age and sex
2 The number of expulsion
2
3
DAFTAR GAMBAR
1
2
3
4
5
Growth pattern in body wight of boys (a) and girls (b)
Growth pattern of body height in boys (a) and girls (b)
Growth pattern of sitting height in boys (a) and girls (b)
Growth pattern of upper arm circumference in boys (a) and girls (b)
Growth pattern of head circumference in boys (a) and girls (b)
4
5
5
6
7
DAFTAR LAMPIRAN
1 The number of probands based on location
2 The questionnaire of proband
3 Comparison of body weigth and body height in boys and girls
between American's child, Bogor's Child, Betawi's child and Bantul
Child
4 Permission of BAPPEDA Bantul
13
14
15
16
1
INTRODUCTION
Background
Growth is one of the phases in the human life cycle. Growth and
development begins from the time of conception to adulthood. Growth may be
defined as a quantitative increase in size or mass, while development is defined as
progession of changes, either quantitative or qualitative, that lead from an
undifferentiated or immature state to highly organized, specialized, and mature
state (Bogin 1999). Growth is influenced by internal factors and external factors.
Internal factor is genetic, hormone, ethnicity or nation, family, age and
chromosomal abnormalities. External factors is environment, social economi and
phsycology (Fox 2002).
Physical measurement of children is required to assess whether the growth
is normal or not. This measurement is important to determine the nutritional status
(Amarita and Veronica 1992), detecting the presence of chronic diseases, and
aberrations in individual growth (Jacob 1981). These assessment need a normal
growth pattern to be used as reference.
The pattern of growth can be determined by anthropometric procedures.
Anthropometry in neonatal and children for assessing nutritional status and
growth that are deemed to be important are measurement of body weight, body
height/lenght, sitting height, upper arm circumference and head circumference.
Suhardjo (1989) explain that a child's weight is a good indicator and overview of
body mass, especially for children under five years old. In this age, body mass is
very sensitive to sudden changes, such as infectious disease, decrease in appetite
or decreasing amount of food consumed (Supariasa & Bakri 2002). Growth of
height is relatively less sensitive than growth of weight in relation to the problem
of malnutrition. Effect of nutrient deficiency on height will only appear in a
relatively long time (Wong 2004). Sitting height is positively correlated with body
mass index in adults, so sitting height can also be used to assess the nutritional
state of children. More over, sitting lenght measurements can also be used to
detect Marfan syndrome and hypochondroplasia syndrome (Bogin and Beydoun
2007). Upper arm circumference tend to increase according to the increase in the
nutritional status of children as well as with increasing age of the child. Head
circumference as an important reflection of growth and development of the brain,
especially in early childhood. Head circumference is also a sensitive
anthropometric indicator of prolonged malnutrition during infancy, so clinicians
use head circumference as a measure of failure to thrive (Bouthoorn 2012). These
anthropometric data are important indicators of the achievement of physical
growth in children (Kuczmarski et al . 2002).
Research on growth patterns of infants and toddlers has been done in Bogor
(Yuliana 2006) and Betawi tribe (Widiastuty 2012). But research on growth
patterns of infants and toddlers in Special Region Yogyakarta has not been done.
2
Aim
The aim of this study is to determine the growth patterns of children 0 – 5
years old in Bantul Special Region Yogyakarta.
MATERIALS AND METHOD
Time and Place
Data was collected during February until April 2014 in Bantul,Yogyakarta.
The sampling was done in four Kindergartens school level, two Integrated
Community Service Post or Pos Pelayanan Terpadu (Posyandu), three Hospitals,
and two by door to door visits (Appendix 1). Data analysis was accomplished in
Section of Biosystematics and Ecology of Animal, Department of Biology, Bogor
Agricultural University.
Sample
The subjects of this research were 320 children 0-5 years old in Bantul
Special Region Yogyakarta. The number of probands based age and sex are
shown in Table 1. Range of age class measured to early birthday. The children in
0 years old is 0 – 6 months, 1 year old is 7 months – 1.5 years old, 2 years old is
1.6 years old – 2.5 years old, 3 years old is 2.6 years old – 3.5 years old, 4 years
old is 3.6 years old – 4.5 years old, and 5 years old is 4.6 years old – 5.5 years old.
Table 1. The number of probands based on age and sex
Age
(years)
0
1
2
3
4
5
Number
Percent(%)
boys
girls
Number
11
15
17
32
40
35
150
46.8
20
16
20
24
42
48
170
53.2
31
31
37
56
82
83
320
100
Probandus in this study had a low socio-economic backgrounds. It is known
from the results of questionnaire (Appendix 2), where the average of expenditure
per month for a family meal ranges between Rp. 750.000 - Rp 1.000.000 from 284
probands who known (Table 2). Average of expulsion is lower than the value of
Wages of Minimum Regional (UMR) in Bantul. Based on decision of the
Governor D.I Yogyakarta Decree. 279/2013 on the Wages of Minimum Regional
(UMR) Bantul in 2014, mentions a large UMR Bantul is Rp. 1.125.500 (Pemda
D.I Yogyakarta 2013).
3
Table 2. The number of expulsion
Expulsion
(Rupiah)
< 500.000
500.00 – 750.000
750.000 – 1.000.000
1.000.000 – 1.250.000
1.250.000 – 1.500.000
>1.500.000
unknown
Number of
Probands
24
57
63
45
42
53
36
Percent (%)
7.5
17.8
19.2
14
13.2
16.6
11.25
Informed Consent
The parents or guardians of children were given detailed information and
they signed the informed consent and completed questionnaires if they agree to
participate.
Measurement
Growth pattern was calculated based on five antrophometric dimensions;
that are, body weight, body height, sitting height, upper arm circumference, and
head circumference.
Body weight was measured by putting baby lying on the baby scale. For
toddlers, body weight was measured using digital weight scale of Uchida.
Proband standing calmly and look straight ahead.
Lenght of baby was measured using measuring board. Proband was placed
in the supine position on a measurements board. They view straight up, their head
hit on the boards. Body and legs of proband were placed horizontal, heel
straightened. For toodlers, body height was measured using stadiometer. Proband
stand upright and relaxed, look straight ahead, heels and knees straightened.
Sitting height was measured as the length from head to rump using
measuring tape. Upper Arm circumference was measured using measuring tape at
the proband’s upper left arm, between the shoulder and elbow, wrapped around
not tensioned. Head circumference was measured using measuring tape. Wrapped
tape around the baby’s head in the part of largest. This is above the eyebrows and
the tops of the ears.
Statistical Analysis
Growth pattern of boys and gils presented by 3rd, 5th, 10th, 25th, 50th, 75th,
90th, 95th, and 97th percentiles at each age group. Generalized additive models for
location scale and shape (GAMLSS) used for determined percentile
(Stasinopoulus and Rigby 2005) and implemented in R program version 2.15.2
(Development Core Team 2012).
4
RESULTS
Body Weight
Growth pattern of body weigt in boys and girls are shown in Figure 1.
Growth pattern of body weigth boys is bigger than girls. Mean of 0 year old in
boys is 5.41 kg and in girls is 5.48 kg. Mean of 1 year old in boys is 9.52 kg and
girls is 8.17 kg. Mean of 2 years old in boys is 10.52 kg and girls is 10.68 kg.
Mean of 3 years in boys is 14.01 kg and girls is 13.00 kg. Mean of 4 years old in
boys is 15.69 kg and girls is 14.40 kg. Mean of 5 years old in boys is 17.29 kg and
girls is 16.73 kg.
%97
%95
girls
25
25
boys
%90
%75
20
20
%97
%95
%90
%75
%50
%25
5
10
15
%10
%5
%3
0
5
10
15
%10
%5
%3
body weight (kg)
%25
0
body weight (kg)
%50
0
1
2
3
4
age(year)
5
6
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 1. Growth pattern in body wight of boys (a) and girls (b)
Body Heigth
Growth pattern of body heigth in boys and girls are shown in Figure 2.
Mean of body height in boys is higher than mean body height in girls. Mean of 0
years in boys is 57.71 cm and in girls is 57.22 cm. Mean of 1 years in boys is
74.33 cm and in girls 72.31 cm. Mean of 2 years old in boys is 83.98 cm and girls
is 83.82 cm. Mean of 3 years in boys is 94.04 cm and girls is 91.71 cm. Mean of 4
years old in boys is 101.70 cm and girls is 99.19 cm. Mean of 5 years old in boys
is 107.5 and girls is 106.2 cm.
5
girls
120
120
boys
%97
%95
%90
%97
%95
%90
%75
%50
110
110
%75
%50
90
80
70
50
60
body height (cm)
100
90
80
70
60
40
50
30
40
30
0
1
2
3
4
5
0
6
1
2
3
4
5
6
age(year)
age(year)
(a)
(b)
Figure 2. Growth pattern of body height in boys (a) and girls (b)
Sitting Height
70
70
Growth pattern of sitting heigth in boys and girls are shown in Figure 3.
Mean of sitting height in boys higher than mean body height’s girls. Mean of 0
years in boys is 36.77 cm and in girls is 36.25 cm. Mean of 1 years in boys is
44.43 cm and in girls 42.64 cm. Mean of 2 years old in boys is 46.79 cm and girls
is 46.00 cm. Mean of 3 years in boys is 52.18 cm and girls is 50.61 cm. Mean of 4
years old in boys is 54.66 cm and girls is 53.68 cm. Mean of 5 years old in boys is
57.32 and girls is 56.30 cm
boys
girls
%97
%95
%97
%95
%90
%75
%90
60
%50
%25
40
50
%10
%5
%3
30
30
40
50
%50
%25
%10
%5
%3
Sitting height (cm)
60
%75
Sitting height (cm)
body height (cm)
%25
%10
%5
%3
100
%25
%10
%5
%3
0
1
2
3
4
age(year)
5
6
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 3. Growth pattern of sitting height in boys (a) and girls (b)
6
Upper Arm Circumference
Growth Pattern of upper arm circumference in boys and girls are shown in
Figure 4. Mean of upper arm circumference in boys is bigger than girls. Mean of 0
years in boys is 13.73 cm and in girls is 13.67 cm. Mean of 1 years in boys is
15.01 cm and in girls 14.42 cm. Mean of 2 years old in boys is 15.08 cm and girls
is 14.52 cm. Mean of 3 years in boys is 16.17 cm and girls is 16.12 cm. Mean of 4
years old in boys is 16.26 cm and girls is 16.18 cm. Mean of 5 years old in boys is
16.69 cm and girls is 16.62 cm.
girls
%90
%75
%50
%25
20
%75
%50
%25
%10
%5
%3
10
15
%10
%5
%3
%90
15
%97
%95
Upper Arm Circumference (cm)
20
%97
%95
10
Upper Arm Circumference (cm)
boys
0
1
2
3
4
age(year)
5
6
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 4. Growth Pattern of upper arm circumference of boys (a) and girls (b)
Head Circumference
Growth pattern of head circumference in boys and girls are shown in Figure
5. Mean of Head Circumference in boys is higher than girls. Mean of 0 years in
boys is 39.30 cm and in girls is 38.60 cm. Mean of 1 years in boys is 45.12 cm
and in girls 44.56 cm. Mean of 2 years old in boys is 47.19 cm and girls is 46.74
cm. Mean of 3 years in boys is 48.81 cm and girls is 48.12 cm. Mean of 4 years
old in boys is 49.70 cm and girls is 48.52 cm. Mean of 5 years old in boys is 50.27
cm and girls is 49.73 cm.
7
55
girls
50
%50
%25
40
45
%10
%5
%3
30
30
35
40
45
%25
%10
%5
%3
Head Circumference (cm)
50
%50
%97
%95
%90
%75
%97
%95
%90
%75
35
Head Circumference (cm)
55
boys
0
1
2
3
4
5
6
age(year)
0
1
2
3
4
5
6
age(year)
(a)
(b)
Figure 5. Growth pattern of head circumference in boys (a) and girls (b)
DISCUSSION
Body Weight
Anthropometric data are valuable objective indicators of attained size and
physical growth in children. Body weight and body height are the mostly
anthropometric data that use to determinate nutritional status of children.
Malnutrition more influence to body weight than body height (Khomsan 2004).
Up to five years old, children’s weight gain significantly. Body mass is very
sensitive to sudden changes, such as infectious disease, decreased appetite or
decreasing the amount of food consumed (Supariasa & Bakri 2002). The pattern
of body weight curves indicates that body mass increases rapidly from birth to
approximately 5 years old. Body weight gain on average 2 − 4 kg every year
during preschool age.
Body weight in boys 0 - 5 years old in Bantul old is bigger than body weight
in girls at each age group. This is because boy have a muscle mass, body mass and
metabolic rate greater than girls (Watson and Lowrey 1951). Body weight in boys
vary for each age which range between 5.41 kg − 17.29 kg, while girls only range
between 5.40 kg − 16.73 kg.
Growth curves are an essential tool in pediatric practice. Their value resides
in helping to determine the degree to which physiological needs for growth and
development are being met during the important childhood period. However, their
usefulness goes far beyond assessing children’s nutritional status (De Onis 2009).
The growth curve of body weight boys and girls showed probandus in under
0.03 percentiles were having body weight smaller in their age group. Some
8
proband in 0.90 percentiles to 0.97 percentiles were having overweight and
proband in above 0.97 percentiles were having obesity in their each age group.
Generally, the child's body weight in Bantul is lower than American
children (De Onis et al. 2006), Bogor children (Yuliana 2006) and Betawi
children (Widiastuty 2013) (Appendix 3). This is probably because the socioeconomic conditions in Bantul was lower than America, Bogor and Betawi tribe.
therefore , it has enviromental, and genetic is different also.
Body Height
The growth pattern of body height much affected by the condition of
malnutrition in the short term. But if prolonged nutritional deficiency and severe,
then the growth pattern of body height can be affected even interfere with the
maturation process. Body height can be inhibited by a protein deficiency despite
sufficient intake energy. The fastest height growth occurs during puberty along
with sexual maturity. Added height and weight along with increasing proportions
of the body (Khomsan 2004).
Body height anthropometric describes the state of skeletal growth. In normal
condition, body height grows with age. Body Height growth unlike weight, its
relatively less sensitive to the problem of malnutrition in a short time. Effect of
nutrient deficiency on height will appear in a relatively long time (Wong 2004).
The pattern of body height curves indicate that body height increases rapidly
from birth to approximately 3 years old. Body height gain average in 0 − 3 years
old is 9 − 16 cm and in 4 − 5 years old average 5 − 8 cm. Body weight in boys 0 5 years old in Bantul is bigger than body weight in girls. Body height in boys
vary for each age which range between 57.71 cm − 107.5 cm, while girls only
range between 57.22 cm − 106.2 cm.
Somatotropin or Growth Hormone (GH) is a major regulator of the growth
framework. Added height is strongly influenced by this hormone. GH stimulates
the formation of somatomedin which then affects the cartilage (Soetjiningsih
1995).
Body height is obtaine similar results with body weight, in which the child's
body height in Bantul is also lower than body height of America children (De
Onis et al. 2006), Bogor children (Yuliana 2006), and Betawi tribe children
(Widiastuty 2013) (Appendix 3).
Sitting Height
Sitting height is correlate positive with body mass index values of children,
therefore, sitting height can also used to assess the nutritional state of children.
Length measurements can also be done seated to detect Marfan syndrome and
Hipokondroplasia syndrome (Bogin & Beydoun 2007). Marfan syndrome (MFS)
is an autosomal dominant connective tissue disorder involving the cardiovascular,
skeletal and ocular systems, the integument, lungs and dura. Cardinal
manifestations include aortic aneurysm and dissection, ocular lens dislocation and
long bone overgrowth. In 90-93% of cases, MFS is caused by mutations in FBN1
(Loeys 2010). Hypochondroplasia is a skeletal dysplasia characterized by short
stature, stocky build, disproportionately short arms and legs, and broad short
9
hands and foot. Hypochondroplasia is a genetic disorder with mostly caused by
mutations in FGFR3 gene (Matsui et al. 1998).
Widiastuty (2012) reported that, can adjust the length of sitting height. If a
child has a higher height , then a child has sitting height longer also.
The pattern of sitting height curves indicates that sitting height increases
rapidly from birth to approximately 3 years old. Body height gain average in 0 − 3
years old is 5 − 7 cm and in 4 − 5 years old gain average 2 cm. Sitting height of
boys vary for each age 0 to 5 years which range between 36.77 cm − 57.32 cm,
while girls only range between 36.25 cm − 56.30 cm.
Upper Arm Circumference
Upper arm circumference is a reflection of the growth and development of
fat tissue and muscle. Upper arm circumference was used to assess nutrition or
growth and development in the preschool age group (Sulistyawati 2014).
The results showed that Upper arm circumference boys is bigger than girls.
Upper arm circumference boys 0 to 5 years old range between 13.79 cm − 16.69
cm and while girls only range between 13.67 cm − 16.62 cm. Upper arm
circumference gain on average 2 cm every year.
Head Circumference
The aim of head circumference measurment for determine childs's head
circumference within the normal range or not. (Bouthoorn et all. 2012) reported
that, several studies recognized head circumference (HC) as an important
reflection of growth and development of the brain, especially in early childhood.
HC is also a sensitive anthropometric indicator of prolonged malnutrition during
infancy, so clinicians use HC as a measure of failure to thrive.
Growth of head circumference associated with brain development. The most
critical period and rapid of brain development is from the fetus in gestation period
until after birth to 2 years old. Brain development is related to the multiplication
and increase size of brain cells quickly. Size cells only increase after 2 years old
(Khomsan 2004).
The pattern of head circumference curves indicates that head circumference
increases rapidly from birth to approximately 2 years old and gain sicnificantly on
average 8 cm. Head circumference boys vary for each age 0 to 5 years old which
range between 39.30 cm − 50.27 cm, while girls only range between 38.60 cm −
49.73 cm.
Brain growth is closely related to malnutrition. Therefore, measure of head
circumference is often used as an indicator to determine nutritional status of child
indicators. Head circumference measurements are sensitive only to a certain age
where brain development is going on. At preschool age, children with
malnutrition have smaller head circumferences than normal children (Khomsan
2004).
10
CONCLUSION
The growth pattern of children 0 − 5 years old in Bantul Special Region
Yogyakarta, showed a similiar pattern in body weight, body height, sitting height,
upper arm circumference and head circumference, which is likely increase.
Average growth of boys bigger than girls at every age group.
REFERENCES
Almarita, Veronica L. 1992. Penggunaan indeks massa tubuh (Body Mess Index)
sebagai indikator status gizi orang dewasa. Gizi Indonesia 17 (1) : 50 – 56.
Bogin B , Beydoun N. 2007. The relationship of sitting height ratio to body mass
index and fatness in the United States 1988-1999. Human Ecology 15: 1-8.
Bouthoorn SH, Van Lenthe FJ, Koelega A, Moll AH, Tiemeier H, Hofman A,
Mackenbach JP, Jaddoe V, Raat H. 2012. Head Circumference of Infants
Born to Mothers with Different Educational Levels; The Generation R
Study. PLoS ONE . 7(6): e39798. doi:10.1371/journal.pone.0039798.
De Onis, Mercedes. 2009. Growth Curves for School-age Children and
Adolescents. Indian Pediatric. 46 : 463 – 465.
De Onis et al. 2006. WHO child growth standards : length/height-for-age, weightfor-age, weight-for-length, weight-forheight and body mass index-for-age :
methods and development. Switzerland (FR) : WHO Press.
Fox SI. 2002. Human Physiology. Ed ke-7. New York (US) : McGraw-Hill.
Jacob T. 1981. Norma Pertumbuhan Untuk Indonesia. Berkala ilmu kedokteran
Gajah Mada Jilid 13. Cetak ulang dalam Indriati E, Editor. 2002.
Antropometri Biologis. Jakarta (ID) : Direktorat Jenderal Pendidikan Tinggi
Departemen Pendidikan Nasional.
Khomsan, A. 2004. Pangan dan gizi untuk kesehatan. Jakarta (ID) : PT. Raja
Grafindo Persada.
Loeys BL et al. 2010. The revised Ghent nosology for the Marfan syndrome. J
Med Genet. 47: 476-485.
Matsui Y, Yasui, Kimura T, Tsumaki, Kawabata, Ochi. Genotype and phenotype
correlation in achondroplasia and hipokondroplasia. 1998. Journal Bone
Joint Surgery. 88: 1052-1057
Pemerintah Daerah D.I Yogyakarta. 2013. Peraturan Gubernur Provinsi Daerah
Istimewa Yogyakarta No. 279/2013 tentang Upah Minimum Provinsi Tahun
2013.
R Development Core Team. 2012. R: A Language and Environment for Statistical
Computing. R Fondation for Statistical Computing, Vienna, Austria. ISBN
3-900051-07-0. http://www.rproject.org/.
Soetjiningsih. 1995. Tumbuh Kembang Anak. Jakarta (ID) : Penerbit Buku
Kedokteran EGC.
Stasinopoulos DM, Rigby RA. 2005. Generalized additive models for location
scale and shape (GAMLSS) in R. Journal Statistics Software. 55:1-64.
Supariasa B, Bakri I F. 2002. Penilaian Status Gizi. Jakarta (ID): Penerbit Buku
Kedokteran EGC.
11
Watson EH, Lowrey GH. 1951. Growth and Development of Children. Ed ke-2.
USA (US) : Year Book.
Widiastuty, H. 2013. Pola Pertumbuhan Anak Usia 1–5 Tahun di Perkampungan
Budaya Betawi Setu Babakan, Jakarta Selatan [Skripsi]. Bogor (ID) :
Fakultas Matematika dan Ilmu Pengetahuan Alam, Institut Pertanian Bogor.
Wong. 2004. Pedoman Klinis Keperawatan Pediatrik. Edisi 4. Jakarta (ID):
Penerbit Buku Kedokteran EGC.
Yuliana. 2006. Pola pertumbuhan Anak Usia 1-5 Tahun di kota Bogor [Skripsi].
Bogor (ID) : Fakultas Matematika dan Ilmu Pengetahuan Alam. Institut
Pertanian Bogor.
12
APPENDIX
13
Appendix 1. The number of probands based on location
Sex
Location
Boys
Girls
Posyandu Kemuning Kec. Kasihan
12
15
Posyandu Prancak Dukuh Kec. Sewon
22
15
RS. PKU Muhammadiyah Bantul
4
5
RS. Panembahan Senopati Bantul
20
32
RS. Ibu Anak Ummi Khasannah
1
4
TK. Aisyiyah Bustanul Alfath Krapyak Wetan
22
27
TK. Kuncup Harapan Sewon
12
23
TK. Taat Insan Mulia Kec. Kasihan
44
37
PAUD. Raudhatul Kec. Sewon
13
10
-
2
150
170
Door to door
Number
14
Appendix 2. The questionnaire of probands
KUISIONER PENELITIAN
Tanggal
ID num
:
:
Data Pribadi
Nama Lengkap
Jenis Kelamin
Alamat (kampung)
:
: P/L
:
Kelurahan :
Tempat Lahir (kampung) :
Tanggal Lahir
:
Usia
:
tahun
Anak ke:
dari
bersaudara
Penyakit (jika ada)
:
Pemberian ASI sampai usia :
Umur berapa mulai non ASI (makan) :
Frekuensi makan per hari :
Pengeluaran perbulan
:
Tinggal di bantul sejak (tanggal/bulan/tahun/) :
Kecamatan :
Data Orang Tua
Nama Ayah
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ibu
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ayah dari Ayah
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ayah dari Ibu
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ibu dari Ayah
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Nama Ibu dari Ibu
Tempat Lahir
Tanggal Lahir
Penyakit (jika ada)
:
:
:
:
Pendapatan keluarga per bulan untuk makan (pilih salah satu) :
1. X < Rp. 500.000
4. Rp. 1.000.000 ≤ X < Rp. 1.250.000
2. Rp. 500.000 ≤ X < Rp. 750.000
5. Rp. 1.250.000 ≤ X < Rp. 1.500.000
3. Rp. 750.000 ≤ X < Rp. 1.000.000
6. Rp. X ≥ Rp. 1.500.000
Ket : X = Total pengeluaran keluarga per bulan untuk makan
Data Pengukuran
No
1
2
3
4
5
Parameter
Berat Badan
Tinggi Badan
Panjang Duduk
Lingkar Lengan
Lingkar Kepala
Tempat pengukuran :
Kode
BB
TB
PD
LL
LK
Hasil Pengukuran
15
Appendix 3. Comparison of body weigth and body height in boys and girls
between American’s child, Bogor’s child, Betawi’s child and
Bantul’s child
Comparison in body weight of 50th percentile
Age
America
Bogor Children Betawi Children Bantul Children
(year)
Children
B
G
B
G
B
G
B
G
1 10.9
10.0
9.6
9.0
8.5
8.2
9.5
8.1
2 13.3
12.7
11.4
10.5
11.3
10.1
10.5
10.6
3 15.3
14.6
13.9
12.5
13.8
11.9
14.0
13.0
4 17.3
17.0
16.0
15.3
15.8
13.8
15.6
14.4
5 18.3
18.2
19.3
17.8
17.9
16.0
17.2
16.7
Comparison in body height of 50th percentile
Age
(year)
1
2
3
4
5
America
Children
B
82.3
91.9
99.2
106.7
110.0
B : boys
G : girls
Bogor Children
G
80.7
90.7
99.0
105.6
109.4
B
77.2
88.6
92.6
102.1
111.0
G
74.7
86.6
93.7
101.3
108.9
Betawi Children Bantul Children
B
74.0
87.9
91.3
101.5
109.8
G
72.5
84.6
92.8
99.5
106.1
B
74.3
83.9
94.0
101.7
107.5
G
72.3
83.8
91.7
99.1
106.2
16
Appendix 4. Permission of BAPPEDA Bantul
17
18
RIWAYAT HIDUP
Penulis dilahirkan di Biak pada tanggal 24 Agustus 1992 dari ayah Suyanto
(Alm) dan ibu Rossiyem. Penulis adalah anak kedua dari dua bersaudara. Tahun
2010 penulis menyelesaikan pendidikan di SMAN 1 Biak Kota dan pada tahun
yang sama penulis melanjutkan studi pada Jurusan Biologi, Fakultas Matematika
dan Ilmu Pengetahuan Alam, Institut Pertanian Bogor melalui jalur USMI.
Selama mengikuti perkuliahan, penulis aktif sebagai bendahara di Divisi
Infokom HIMABIO sebagai bendahara pada tahun 2012/2013 dan pada tahun
2013/2014 penulis menjadi asisten praktikum Fisiologi Prokariot.
Penulis melakukan Studi Lapangan dengan judul Invertarisasi Fauna Air di
Taman Nasional Gunung Pangrango pada tahun 2012 dan melakukan Praktik
Lapangan dengan judul Perawatan dan pengamatan tingkah laku Snow Leopard
(Panthera uncia) di Taman Safari Indonesia Cisarua – Bogor pada tahun 2013.
19