The association between stress and high-fat intake with hypertension among pregnant women in Bondowoso Regency
Hypertension affects approximately 10% of pregnancies globally and remains a leading cause of maternal mortality and morbidity. Mothers with hypertension in their first pregnancy are at an elevated risk for preeclampsia in subsequent pregnancies. This study aimed to analyze the relationship between stress and high-fat intake and the incidence of hypertension in pregnant women. This was an observational study that used a cross-sectional approach from May to June 2024. The study population included pregnant women who were patients of the Maesan Health Center and residing in Bondowoso Regency. The sample selection used Slovin's formula: 73 out of 263 pregnant women. Stress variables were measured using the Revised Prenatal Distress Questionnaire (NuPDQ), a 2 × 24-hour recall questionnaire for fat intake measurements, and blood pressure measurements using a tensimeter. Univariate analysis described each variable, including respondents' stress status and high-fat dietary intake. Moreover, bivariate analysis used chi-square tests to assess the relationship between the independent variables (stress and fat intake) and the dependent variable (hypertension). This study found that there was an association between stress and high-fat intake and the incidence of hypertension, with p-values <0,001 and <0,001, respectively. We recommend addressing both stress management and dietary habits as crucial in prenatal care programmes.
Keywords : Hypertension, pregnancy, stress, fat dietary intake
- Abera, T. (2018). Pregnancy Induced Hypertension and Associated Factors Among Pregnant Women Receiving Antenatal Care Service at Jimma Town Public Health Facilities, South West Ethiopia. Journal of Gynecology and Womens Health, 10(4). https://doi.org/10.19080/jgwh.2018.10.555792
- Al-Mutawtah, M., Campbell, E., Kubis, H. P., & Erjavec, M. (2023). Women’s experiences of social support during pregnancy: a qualitative systematic review. BMC Pregnancy and Childbirth, 23(1). https://doi.org/10.1186/s12884-023-06089-0
- Anyanwu, O., Folta, S. C., Zhang, F. F., Chui, K., Chomitz, V. R., Kartasurya, M. I., & Naumova, E. N. (2022). A Cross-Sectional Assessment of Dietary Patterns and Their Relationship to Hypertension and Obesity in Indonesia. Current Developments in Nutrition, 6(6), nzac091. https://doi.org/10.1093/cdn/nzac091
- Badan Pusat Statistik. (2023). Jumlah Kasus Penyakit Angka Penemuan TBC, Keberhasilan Pengobatan TBC, Kasus Baru AIDS Menurut Kabupaten/Kota di Provinsi Jawa Timur, 2022. https://jatim.bps.go.id/statictable/2023/07/24/2976/-jumlah-kasus-penyakit-angka-penemuan-tbc-keberhasilan-pengobatan-tbc-kasus-baru-aids-menurut-kabupaten-kota-di-provinsi-jawa-timur-2022.html
- Chang, K. J., Seow, K. M., & Chen, K. H. (2023). Preeclampsia: Recent Advances in Predicting, Preventing, and Managing the Maternal and Fetal Life-Threatening Condition. In International Journal of Environmental Research and Public Health (Vol. 20, Issue 4). MDPI. https://doi.org/10.3390/ijerph20042994
- Cífková, R. (2023). Hypertension in Pregnancy: A Diagnostic and Therapeutic Overview. In High Blood Pressure and Cardiovascular Prevention (Vol. 30, Issue 4, pp. 289–303). Adis. https://doi.org/10.1007/s40292-023-00582-5
- Crume, T., Brinton, J. T., Shapiro, A., Kaar, J. L., Glueck, D. H., Siega‐Riz, A. M., & Dabelea, D. (2016). Maternal Dietary Intake During Pregnancy and Offspring Body Composition: The Healthy Start Study. American Journal of Obstetrics and Gynecology, 215(5), 609.e1-609.e8. https://doi.org/10.1016/j.ajog.2016.06.035
- Damen, N. A., Gillingham, M. B., Hansen, J., Thornburg, K. L., Purnell, J. Q., & Marshall, N. (2021). Maternal Dietary Fat Intake During Pregnancy and Newborn Body Composition. Journal of Perinatology, 41(5), 1007–1013. https://doi.org/10.1038/s41372-021-00922-0
- Draganović, D., Lucic, N., & Jojić, D. (2016). Oxidative Stress Marker and Pregnancy Induced Hypertension. Medical Archives, 70(6), 437. https://doi.org/10.5455/medarh.2016.70.437-440
- Fauziyah, R., & Anggraeni, W. (2023). Analysis Of The Level Of Primigravida Anxiety In Facing The Labor Process In Terms Of Education On The Labor Process In The Room Maternity Clinic Pratama Eka Medika, Mojosari-Mojokerto. In JSRET (Journal of Scientific (Vol. 2, Issue 2).
- Fitri, N. L., HS, S. A. S., Dewi, N. R., & Nurhayati, S. (2022). Hubungan Usia Ibu dengan Kejadian KEK pada Ibu Hamil di Wilayah Kerja Puskesmas Ganjar Agung Kecamatan Metro Barat Kota Metro. Wacana Kesehatan, 7(1).
- Gunawan, S. P., & Adriani, M. (2020). Obesitas Dan Tingkat Stres Berhubungan Dengan Hipertensi Pada Orang Dewasa di Kelurahan Klampis Ngasem, Surabaya. Media Gizi Indonesia. 2020, 15(2), 119–126. https://doi.org/10.204736/mgi.v15i2.119-126
- Güner, Ö., & Öztürk, R. (2022). Psychological and Social Impact and Lifestyle Changes Among Pregnant Women of COVID-19 Pandemic: A Qualitative Study. Archives of Psychiatric Nursing, 36, 70–77. https://doi.org/10.1016/j.apnu.2021.12.005
- Herhaus, B., Ullmann, E., Chrousos, G. P., & Petrowski, K. (2020). High/Low Cortisol Reactivity and Food Intake in People With Obesity and Healthy Weight. Translational Psychiatry, 10(1). https://doi.org/10.1038/s41398-020-0729-6
- Himes, K. P., & Simhan, H. N. (2010). Plasma Corticotropin-Releasing Hormone and Cortisol Concentrations and Perceived Stress Among Pregnant Women With Preterm and Term Birth. American Journal of Perinatology, 28(06), 443–448. https://doi.org/10.1055/s-0030-1270119
- Iffah, U., Yulizawati, Y., Lisa, U. F., Insani, A. A., Fitria, H., & Taufia, D. (2023). Benson’s Relaxation on Anxiety and Blood Pressure in Pregnant Women With Hypertension in Pregnancy. Indonesian Journal of Multidisciplinary Science, 3(1), 91–95. https://doi.org/10.55324/ijoms.v3i1.673
- Iino, K., Higuchi, T., Nakaji, S., Yokoyama, Y., & Mizunuma, H. (2023). Association Between the Change in Blood Pressure During Normotensive Pregnancy and the Development of Hypertension in Later Life. Jma Journal, 6(1), 48–54. https://doi.org/10.31662/jmaj.2022-0102
- Lembaga Ilmu Pengetahuan Indonesia. (2018). Rumusan Rekomendasi Widyakarya Nasional Pangan dan Gizi (WNPG) XI.
- Lobel, M., Cannella, D. L., Graham, J. E., DeVincent, C., Schneider, J., & Meyer, B. A. (2008). Pregnancy-Specific Stress, Prenatal Health Behaviors, and Birth Outcomes. Health Psychology, 27(5), 604–615. https://doi.org/10.1037/a0013242
- Miliku, K., Bergen, N., Bakker, H., Hofman, A., Steegers, E. A. P., Gaillard, R., & Jaddoe, V. W. V. (2016). Associations of Maternal and Paternal Blood Pressure Patterns and Hypertensive Disorders During Pregnancy With Childhood Blood Pressure. Journal of the American Heart Association, 5(10). https://doi.org/10.1161/jaha.116.003884
- Ministry of Health of Indonesia. (2024). Prevalensi, Dampak, serta Upaya Pengendalian Hipertensi & Diabetes di Indonesia. https://p2ptm.kemkes.go.id/uploads/cEdQdm1WVXZuRXhad3FtVXduOW1WUT09/2024/09/factsheet%20PTM%2024aprl07.30.pdf
- Mitran, A. M., Gherasim, A., Niță, O., Mihalache, L., Arhire, L. I., Cioancă, O., Gafițanu, D., & Popa, A. D. (2024). Exploring Lifestyle and Dietary Patterns in Pregnancy and Their Impact on Health: A Comparative Analysis of Two Distinct Groups 10 Years Apart. Nutrients, 16(3). https://doi.org/10.3390/nu16030377
- Naibaho, F. (2021). Faktor-Faktor yang Berhubungan dengan Kejadian Hipertensi di Puskesmas Nunpene Kabupaten Timor Tengah Utara Tahun 2018. Intelektiva: Jurnal Ekonomi, Sosial & Humaniora, 2(12).
- Nurhasanah, A., Wardiyah, A., & Rilyani, R. (2023). Faktor yang Berhubungan dengan Stres pada Ibu Hamil selama Pandemi di Wilayah Kerja Puskesmas Bandar Jaya Kabupaten Lampung Tengah. Malahayati Nursing Journal, 5(1), 23–36. https://doi.org/10.33024/mnj.v5i1.7636
- Obeagu, E. I., Muhimbura, E., & Obeagu, G. U. (2024). Hypoxia-Induced Oxidative Stress: Maternal and Fetal Implications. In Pp. Elite Journal of Haematology (Vol. 2, Issue 8). https://epjournals.com/journals/EJH
- Oddo, V. M., Maehara, M., & Rah, J. H. (2019). Overweight in Indonesia: An Observational Study of Trends and Risk Factors Among Adults and Children. BMJ Open, 9(9), e031198. https://doi.org/10.1136/bmjopen-2019-031198
- O’Donnell, M. G., Stumpp, L., Gallaher, M. J., & Powers, R. W. (2023). Pre-Pregnancy Stress Induces Maternal Vascular Dysfunction During Pregnancy and Postpartum. Reproductive Sciences, 30(11), 3197–3211. https://doi.org/10.1007/s43032-023-01248-2
- Omertayeva, D., Ponamaryova, O., Amirbekova, Z., Vazenmiller, D., & Mugazov, M. (2020). Diagnostic Value of Determining the Level of Purine Metabolism Intermediates in Pregnant Women With Chronic Hypertension and Superimposed Preeclampsia. Journal of Nephropathology, 10(3), e25–e25. https://doi.org/10.34172/jnp.2021.25
- Paknahad, Z., Fallah, A., & Moravejolahkami, A. R. (2019). Maternal Dietary Patterns and Their Association With Pregnancy Outcomes. Clinical Nutrition Research, 8(1), 64. https://doi.org/10.7762/cnr.2019.8.1.64
- Palomo-Gómez, R., Rúger-Navarrete, A., Antúnez-Calvente, I., Vázquez-Lara, J. M., Rodríguez-Díaz, L., Gómez-Salgado, J., Riesco-González, F. J., Vázquez-Lara, M. D., Muñoz-Vela, F. J., & Fernández-Carrasco, F. J. (2024). Prenatal Stress as a Risk Factor for Maternal–Foetal Morbidity: A Longitudinal Study. Healthcare, 12(3), 312. https://doi.org/10.3390/healthcare12030312
- Preis, H., Mahaffey, B., & Lobel, M. (2020). Psychometric Properties of the Pandemic-Related Pregnancy Stress Scale (PREPS). Journal of Psychosomatic Obstetrics & Gynecology, 41(3), 191–197. https://doi.org/10.1080/0167482x.2020.1801625
- Riskesdas. (2018). Laporan Nasional Riset Kesehatan 2018. In Balitbang Kementerian Kesehatan RI.
- Sackey, D. S., Larbie, C., & Mensah, F. O. (2018). Geophagia, Nutrition and Health of Women With Pregnancy-Induced Hypertension. African Health Sciences, 18(4), 1243. https://doi.org/10.4314/ahs.v18i4.46
- Santoso, J. B. (2018). Pengembangan Skala Revised Prenatal Distress Questionnaire (NuPDQ) Versi Bahasa Indonesia. Jurnal Ilmiah Psikologi MANASA, 7(1), 62–71.
- Sihaloho Jurusan Kebidanan, E., & Kebidanan, A. (2024). Hubungan Stres Dengan Kejadian Hipertensi Pada Ibu Hamil Primigravida. In Jurnal Keperawatan (Vol. 12, Issue 1).
- Singh, D. K., Sinha, Ν. Κ., Bera, O. P., Saleem, S. M., Tripathi, S., Shikha, D., Goyal, M., & Bhattacharya, S. (2021). Effects of Diet on Hypertensive Disorders During Pregnancy. Journal of Family Medicine and Primary Care, 10(9), 3268–3272. https://doi.org/10.4103/jfmpc.jfmpc_96_21
- Stephansson, O., & Sandström, A. (2024). Can short- and long-term maternal and infant risks linked to hypertension and diabetes during pregnancy be reduced by therapy? In Journal of Internal Medicine (Vol. 296, Issue 3, pp. 216–233). John Wiley and Sons Inc. https://doi.org/10.1111/joim.13823
- Suharta, & Anggrianti, D. (2021). Konseling Lifestyle Modification Pada Individu Dengan Hipertensi di Bondowoso. MEDICAL JOURNAL OF AL-QODIRI, 6(1), 26–34.
- Walther, L.-M., & Wirtz, P. H. (2023). Physiological Reactivity to Acute Mental Stress in Essential Hypertension—a Systematic Review. Frontiers in Cardiovascular Medicine, 10. https://doi.org/10.3389/fcvm.2023.1215710
- Wang, Z., Wang, C., Qiu, J., Ni, Y., Chai, S., Zhou, L., Li, J., Yan, B., Yang, J., & Liu, Q. (2018). The Association Between Dietary Vitamin C/E and Gestational Hypertensive Disorder: A Case-Control Study. Journal of Nutritional Science and Vitaminology, 64(6), 454–465. https://doi.org/10.3177/jnsv.64.454
- Watanabe, K., Mori, T., Iwasaki, A., Kimura, C., Matsushita, H., Shinohara, K., & Wakatsuki, A. (2013). Increased Oxygen Free Radical Production During Pregnancy May Impair Vascular Reactivity in Preeclamptic Women. Hypertension Research, 36(4), 356–360. https://doi.org/10.1038/hr.2012.208
- World Health Organization. (2025, January). Hypertension. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hypertension
Copyright (c) 2025 Amalina Hilyatu Sholihah, Adistha Eka Noveyani, Abdul Azis Akbar

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.