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Stunting and its associated factors among 6-7-year-old children in southern Iran: a nested case-control study
Mohammad Javad Fatemi1, Mohammad Fararouei2, Hossein Moravej3
1Student Research Committee, Center for Health Sciences, Department of Epidemiology,School of Health, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran.
Insights
Maternal occupation, childhood diseases, and dietary factors like dairy and animal protein intake are linked to childhood stunting in Iran. Higher family income and longer breastfeeding duration may reduce stunting risk.
Area of Science:
- Pediatrics
- Public Health
- Nutrition Science
Background:
- Childhood stunting, defined as height-for-age below the 3rd percentile or 2 standard deviations below the median, is a significant public health concern.
- Identifying associated factors is crucial for developing effective interventions to improve child growth and development.
Purpose of the Study:
- To investigate the association between various factors and stunting in a cohort of Iranian children.
- To provide insights into modifiable risk and protective factors for childhood stunting.
Main Methods:
- A nested case-control study was conducted in Shiraz, Iran, in 2016.
- The study included 200 children with stunting (cases) and 200 children with normal height (controls) born between 2009 and 2010.
Main Results:
- Maternal employment was associated with increased stunting risk (adjusted OR: 3.58).
- Chronic childhood diseases (adjusted OR: 2.93), low family income (adjusted OR: 5.63), low dairy consumption (adjusted OR: 5.93), and low animal protein intake (adjusted OR: 2.42) were significantly associated with stunting.
- Conversely, longer birth intervals (adjusted OR: 3.13) and exclusive breastfeeding for 18-24 months (adjusted OR: 0.53) were inversely associated with stunting.
Conclusions:
- Maternal occupation (housewife), childhood diseases, and dairy consumption are identified as strong, modifiable factors influencing Iranian children's stature.
- Family income is a significant factor, though less controllable by parents.
- Interventions targeting maternal employment, childhood illness management, and dietary improvements, particularly dairy intake, could positively impact children's growth.
Objective:
Height-for-age shorter than 3th percentile or 2 sd below the median of the National Center for Health Statistics/WHO growth reference is known as stunting. The present study aimed to measure the association of several factors with stunting in a cohort born from 2009 to 2010 in Shiraz, Iran.
Design/Setting/Subjects:
Nested case-control study conducted on pre-school children in 2016. Participants were 200 children suffering from stunting (case group) and 200 children with normal height (control group).
Results:
Results of multivariable logistic regression analysis suggested a significant relationship (adjusted OR; 95 % CI) between stunting and mother's occupation (employed v. housewife: 3·58; 1·73, 7·39) and chronic diseases (yes v. no: 2·93; 1·25, 6·88). In addition, significant associations were found between family income (<10 million v. >30 million Rials: 5·63; 2·46, 12·87), diary consumption (very little v. high: 5·93; 1·74, 20·18) and animal protein in diet (low v. very high: 2·42; 1·13, 5·19) and stunting among children. Also, chance of stunting was inversely associated with birth interval (<2 years v. first child: 3·13; 1·45, 6·76) and duration of exclusive breast-feeding (18-24 months v. formula only or breast-feeding for <18 months: 0·53; 0·30, 0·92).
Conclusions:
Mothers being housewife, possibly due to having more time to take care of their children, childhood diseases and consumption of dairy foods are strong and modifiable factors which can positively affect Iranian children's stature. Higher family income is another important factor in stunting but under less parental control.
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