Analisis Determinan Tingkat Keparahan Stunting pada Balita di Wilayah Kerja Puskesmas Pilolodaa: Analysis of Determinants of Stunting Severity Among Toddlers in the Service Area of the Pilolodaa Community Health Center

Stunting masih menjadi masalah gizi di Indonesia, termasuk di wilayah kerja Puskesmas Piloladaa, Kota Gorontalo dengan prevalensi 28% jauh melampaui target nasional 14%. Kajian yang secara khusus menganalisis determinan tingkat keparahan stunting (pendek vs sangat pendek) masih terbatas, khususnya di Gorontalo. Penelitian ini bertujuan menganalisis hubungan antara pola asuh, riwayat kehamilan, dan status imunisasi dengan tingkat keparahan stunting pada balita di wilayah kerja Puskesmas Pilolodaa. Desain penelitian adalah cross-sectional dengan sampel 162 balita stunting yang dipilih melalui simple random sampling. Data dikumpulkan melalui wawancara terstruktur dan penelusuran catatan medis, kemudian dianalisis secara bertahap melalui uji Chi-Square dan regresi logistik berganda. Hasil menunjukkan mayoritas balita mengalami stunting kategori sangat pendek (69,1%). Ketiga variabel berhubungan signifikan dengan keparahan stunting pada analisis bivariat (p<0,05). Analisis multivariat mengonfirmasi riwayat kehamilan sebagai prediktor paling dominan (OR=0,103; 95% CI 0,044–0,244), diikuti pola asuh (OR=0,342; 95% CI 0,154–0,759), keduanya bersifat protektif. Status imunisasi juga signifikan (OR=2,486; 95% CI 1,113–5,552), namun dengan arah yang memerlukan kajian lebih lanjut. Riwayat kehamilan, pola asuh dan status imunisasi berhubungan signifikan dengan tingkat keparahan stunting dengan riwayat kehamilan sebagai faktor paling berpengaruh. Diharapkan agar dapat memperkuat pemantauan kehamilan berisiko dan edukasi pola asuh sejak masa kehamilan sebagai intervensi prioritas. Stunting remains a nutritional problem in Indonesia, including in the service area of the Piloladaa Community Health Center (Puskesmas) in Gorontalo City, where the prevalence of 28% far exceeds the national target of 14%. Studies specifically analyzing the determinants of stunting severity (short vs. severely short) remain limited, particularly in Gorontalo. This study aims to analyze the relationship between parenting practices, pregnancy history, and immunization status with the severity of stunting among toddlers in the service area of the Piloladaa Community Health Center. The study design was cross-sectional, with a sample of 162 stunted toddlers selected through simple random sampling. Data were collected through structured interviews and medical record reviews, then analyzed in stages using the Chi-Square test and multiple logistic regression. The results showed that the majority of toddlers were in the severely stunted category (69.1%). All three variables were significantly associated with the severity of stunting in the bivariate analysis (p<0.05). Multivariate analysis confirmed pregnancy history as the most dominant predictor (OR = 0.103; 95% CI 0.044–0.244), followed by parenting practices (OR = 0.342; 95% CI 0.154–0.759), both of which were protective factors. Immunization status was also significant (OR = 2.486; 95% CI 1.113–5.552), though the direction of this association warrants further study. Pregnancy history, parenting practices, and immunization status were significantly associated with the severity of stunting, with pregnancy history being the most influential factor. It is hoped that this will strengthen monitoring efforts.