Keywords
High-risk pregnancy
Home visit
Maternal weight
Midwifery care
How to Cite
Abstract
Low birth weight and poor maternal nutritional status remain important public health concerns, particularly among women with high-risk pregnancies. Limited family involvement may reduce adherence to nutritional recommendations and antenatal care, thereby contributing to suboptimal maternal outcomes. This study aimed to evaluate the association of structured home visits combined with family-centered midwifery care with family support and maternal weight among women with high-risk pregnancies. This quasi-experimental study used intervention and control groups with repeated measurements. A total of 104 pregnant women were initially enrolled, with 52 participants in each group. Four participants did not complete the study: two women in the intervention group relocated, whereas one woman in the control group relocated and one voluntarily withdrew. The final analysis included 100 participants, with 50 women in each group. The intervention group received structured home visits, early risk detection, individualized nutritional counseling, maternal health monitoring, and active family involvement for 12 weeks, whereas the control group received routine antenatal care. Maternal weight was measured repeatedly from baseline to the third trimester. Data were analyzed using association analysis, repeated-measures ANOVA, an independent-samples t-test, ANCOVA, and multiple linear regression. Assignment to the intervention group was statistically associated with a higher family-support score (point-biserial r=0.724; 95% CI: 0.615–0.806; p<0.001). At the third-trimester measurement, mean maternal weight was 57.80±7.96 kg in the intervention group and 51.02±6.69 kg in the control group. The mean difference was 6.78 kg (95% CI: 3.86–9.69; p<0.001). After adjustment for maternal age, education, occupation, and parity, the group effect remained statistically significant (F=19.852; p<0.001; partial η²=0.174). Family support had a statistically significant individual regression coefficient (B=3.288; 95% CI: 0.819–5.758; p=0.010); however, the overall regression model was not statistically significant (R²=0.088; p=0.117). Structured home visits combined with family-centered midwifery care were associated with higher family support and higher third-trimester maternal weight among women with high-risk pregnancies. These findings should be interpreted cautiously because of the nonrandomized design and the absence of formal mediation analysis.
References
Aji, A. S., Lipoeto, N. I., Yusrawati, Y., Malik, S. G., Kusmayanti, N. A., Susanto, I., Majidah, N. M., Nurunniyah, S., Alfiana, R. D., Wahyuningsih, W., & Vimaleswaran, K. S. (2022). Association between pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes: a cohort study in Indonesian pregnant women. BMC Pregnancy and Childbirth, 22(1), 492. https://doi.org/10.1186/s12884-022-04815-8
Aung, W., Saw, L., & Sweet, L. (2022). An integrative review of interventions for limiting gestational weight gain in pregnant women who are overweight or obese. Women and Birth, 35(2), 108–126. https://doi.org/10.1016/j.wombi.2021.04.009
Barrera, A. Z., Morris, S. Y., & Ruiz, A. (2022). Mothers and Babies Online Course: Participant Characteristics and Behaviors in a Web-Based Prevention of Postpartum Depression Intervention. Frontiers in Global Women’s Health, 3, 846611. https://doi.org/10.3389/fgwh.2022.846611
Barroso, C. S., Yockey, A., Degon, E., Gautam Poudel, P., Brown, S. D., Hedderson, M. M., Moreno-Hunt, C., & Ehrlich, S. F. (2022). Efficacious lifestyle interventions for appropriate gestational weight gain in women with overweight or obesity set in the health care system: a scoping review. The Journal of Maternal-Fetal & Neonatal Medicine, 35(25), 6411–6424. https://doi.org/10.1080/14767058.2021.1914576
Biaggi, A., Zonca, V., Anacker, C., Begni, V., Benedetti, F., Bramante, A., Braniecka, A., Brenna, V., Bulgheroni, M., Buss, C., Cavaliere, L., Cecil, C. A. M., Couch, A. C., de Barra, D., El Marroun, H., Entringer, S., Grassi-Oliveira, R., Jackowska, M., Korosi, A., … Cattaneo, A. (2025). Understanding, predicting, and treating depression in pregnancy to improve mothers’ and offspring’s mental health outcomes: The HappyMums study. Brain, Behavior, & Immunity - Health, 44, 100961. https://doi.org/10.1016/j.bbih.2025.100961
BKPK. (2023). Survei Kesehatan Indonesia (SKI). https://www.slideshare.net/slideshow/survei-kesehatan-indonesia-ski-tahun-2023/269424965#1
BPS Kota Makassar. (2024). Kota Makassar Dalam Angka 2024. https://makassarkota.bps.go.id/id/publication/2024/02/28/d2d5c2bc66347ad3ddbd8bd1/kota-makassar-dalam-angka-2024.html
de Wolff, M. G., Midtgaard, J., Johansen, M., Rom, A. L., Rosthøj, S., Tabor, A., & Hegaard, H. K. (2021). Effects of a Midwife-Coordinated Maternity Care Intervention (ChroPreg) vs. Standard Care in Pregnant Women with Chronic Medical Conditions: Results from a Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 18(15), 7875. https://doi.org/10.3390/ijerph18157875
Deshpande, S., Ross, S., Rajesh, S., & Kallioinen, M. (2025). Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years—summary of new NICE guidance. BMJ, 389, r954. https://doi.org/10.1136/bmj.r954
Dilworth, S., Doherty, E., Mallise, C., Licata, M., Hollis, J., Wynne, O., Lane, C., Wolfenden, L., Wiggers, J., & Kingsland, M. (2024). Barriers and enablers to addressing smoking, nutrition, alcohol consumption, physical activity and gestational weight gain (SNAP-W) as part of antenatal care: A mixed methods systematic review. Implementation Science Communications, 5(1), 112. https://doi.org/10.1186/s43058-024-00655-z
Fikre, R., Gubbels, J., Teklesilasie, W., & Gerards, S. (2023). Effectiveness of midwifery-led care on pregnancy outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy and Childbirth, 23(1), 386. https://doi.org/10.1186/s12884-023-05664-9
Hanifi, M., Liu, W., Twynstra, J., & Seabrook, J. A. (2024). Does Dietitian Involvement During Pregnancy Improve Birth Outcomes? A Systematic Review. Canadian Journal of Dietetic Practice and Research, 85(1), 32–44. https://doi.org/10.3148/cjdpr-2023-014
Hunter, P. J., Muthiani, Y., Näsänen-Gilmore, P. K., Koivu, A. M., Pörtfors, P., Bastola, K., Vimpeli, R., Luoma, J., Ashorn, U., & Ashorn, P. (2023). A modular systematic review of antenatal interventions to address undernutrition during pregnancy in the prevention of low birth weight. The American Journal of Clinical Nutrition, 117(Suppl 2), S134–S147. https://doi.org/10.1016/j.ajcnut.2023.01.024
Kartika, K., Rukmini, S. D., Haksama, S., Ismuntania, I., & Rakhman, F. (2024). Determinant factors of antenatal care used by pregnant women in Indonesia: A systematic review. African Journal of Reproductive Health, 28(10s), 226–238. https://doi.org/10.29063/ajrh2024/v28i10s.27
Laksono, A. D., Wulandari, R. D., Widya Sukoco, N. E., & Suharmiati, S. (2022). Husband’s involvement in wife’s antenatal care visits in Indonesia: What factors are related? Journal of Public Health Research, 11(2), 22799036221104156. https://doi.org/10.1177/22799036221104156
Lapian, L. G., Zulkifli, A., Razak, A., & Sidin, I. (2022). A Quasi-Experimental Study: Can Self-Leadership Training and Emotional Intelligence Mentoring Lower Burnout Rates in Hospital Nurses? Open Access Macedonian Journal of Medical Sciences, 10(E), 905–912. https://doi.org/10.3889/oamjms.2022.8756
Mackeen, A. D., Young, A. J., Lutcher, S., Hetherington, V., Mowery, J. W., Savage, J. S., Symons Downs, D., & Bailey‐Davis, L. (2022). Encouraging appropriate gestational weight gain in high‐risk gravida: A randomized controlled trial. Obesity Science & Practice, 8(3), 261–271. https://doi.org/10.1002/osp4.565
Mitchell, A. M., Kowalsky, J. M., Christian, L. M., Belury, M. A., & Cole, R. M. (2022). Perceived social support predicts self-reported and objective health and health behaviors among pregnant women. Journal of Behavioral Medicine, 45(4), 589–602. https://doi.org/10.1007/s10865-022-00306-5
Owoputi, I., Hoddinott, J., Kayanda, R., Bezner Kerr, R., & Dickin, K. (2024). Community Health Workers’ Targeting of Women For Health and Nutrition Home Visits in Rural Tanzania: A Mixed-Methods Study. Current Developments in Nutrition, 8(6), 103780. https://doi.org/10.1016/j.cdnut.2024.103780
Paratmanitya, Y., Helmyati, S., Nurdiati, D. S., Lewis, E. C., Gittelsohn, J., & Hadi, H. (2021). The effect of a maternal mentoring program on the timing of first antenatal care visit among pregnant women in Bantul, Indonesia: Results of a cluster randomized trial. Health Promotion Perspectives, 11(3), 307–315. https://doi.org/10.34172/hpp.2021.39
Patil, S. R., Nimmagadda, S., Gopalakrishnan, L., Avula, R., Bajaj, S., Diamond-Smith, N., Paul, A., Fernald, L., Menon, P., & Walker, D. (2022). Can digitally enabling community health and nutrition workers improve services delivery to pregnant women and mothers of infants? Quasi-experimental evidence from a national-scale nutrition programme in India. BMJ Global Health, 6(Suppl 5), e007298. https://doi.org/10.1136/bmjgh-2021-007298
Prina, E., Ceccarelli, C., Abdulmalik, J. O., Amaddeo, F., Cadorin, C., Papola, D., Tol, W. A., Lund, C., Barbui, C., & Purgato, M. (2023). Task-sharing psychosocial interventions for the prevention of common mental disorders in the perinatal period in low- and middle-income countries: A systematic review and meta-analysis. International Journal of Social Psychiatry, 69(7), 1578–1591. https://doi.org/10.1177/00207640231174451
Teede, H. J., Bailey, C., Moran, L. J., Bahri Khomami, M., Enticott, J., Ranasinha, S., Rogozińska, E., Skouteris, H., Boyle, J. A., Thangaratinam, S., & Harrison, C. L. (2022). Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes. JAMA Internal Medicine, 182(2), 106. https://doi.org/10.1001/jamainternmed.2021.6373
Vigod, S. N., Frey, B. N., Clark, C. T., Grigoriadis, S., Barker, L. C., Brown, H. K., Charlebois, J., Dennis, C.-L., Fairbrother, N., Green, S. M., Letourneau, N. L., Oberlander, T. F., Sharma, V., Singla, D. R., Stewart, D. E., Tomasi, P., Ellington, B. D., Fleury, C., Tarasoff, L. A., … Van Lieshout, R. J. (2025). Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troub. The Canadian Journal of Psychiatry, 70(6), 429–489. https://doi.org/10.1177/07067437241303031
WHO. (2023). Nutrition counselling during pregnancy. In e-Library of Evidence for Nutrition Actions (eLENA). World Health Organization. https://www.who.int/tools/elena/interventions/nutrition-counselling-pregnancy
WHO and UNICEF. (2025). Global nutrition targets 2030: Low birth weight brief. World Health Organization and the United Nations Children’s Fund (UNICEF). https://www.who.int/publications/i/item/B09402
Wulandari, R. D., Laksono, A. D., & Matahari, R. (2022). Does Husband’s Education Level Matter to Antenatal Care Visits? A Study on Poor Households in Indonesia. Indian Journal of Community Medicine, 47(2), 192–195. https://doi.org/10.4103/ijcm.ijcm_981_21
Zhou, M., Peng, X., Yi, H., Tang, S., & You, H. (2022). Determinants of excessive gestational weight gain: a systematic review and meta-analysis. Archives of Public Health, 80(1), 129. https://doi.org/10.1186/s13690-022-00864-9
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