ESPE2024 Free Communications Growth and Syndromes (6 abstracts)
1Institute of Endocrinology and Diabetes, Schneider Children's Medical Center, Petach Tikva, Israel. 2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4Ministry of Health, Jerusalem, Israel. 5Department of Health, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel, Tel Aviv, Israel. 6Hebrew University of Jerusalem–Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. 7Faculty of Welfare and Health, School of Public Health University of Haifa, Haifa, Israel
Background and aims: Disparities in children's height often reflect socio-economic inequalities. Our aims were: (A) to describe anthropometric and socio-demographic data of children with short stature (CDC based height-z score<-2SDS) at age 6-7 years, compared to peers with height-z score≥-2SDS. (B) To assess risk factors for short stature at age 6-7 years based on growth and socio-demographic data at age 0-2 years.
Methods: This is a retrospective case-control study. Anonymized anthropometrics measured as part of the Israeli Ministry of Health Growth Survey during the first grade between the years 2015-2019 were collected. Participants were divided by sectors (Secular / Religious Jews, Ultra-orthodox Jews (UOJ), Arabs, Bedouins, Druze) according to their school's affiliation. Growth and socio-demographic data were extracted for each child from the national Tipat Halav clinics (Family Care Centers) computerized records.
Results: The study included 368,088 children, with a median age of 6.7 (IQR 6.3-7.0). Children with short stature had lower BMI-z scores, lower socio-economic position (SEP) scores, higher SGA and lower LGA rates than controls. Short stature was most prevalent in UOJ boys (3.8%) and girls (3.2%), and least prevalent in Arab boys (0.8%) and girls (0.7%) compared to all other sectors. All between-group comparisons were significant (P <0.001). In a logistic regression model, variables which were predictive of short stature at age 6-7 years were: female sex, greater gestational age at birth, lower height-z at age 0-4 months, birth weight<90th percentile for gestational age, being in the UOJ sector, and having a lower Δheight-z score during the first 2 years of life.
Short stature n = 6145, (1.7%) |
Normal height n = 361,943, (98.3%) |
|
Sex n (%) Male Female |
3237 (1.7) 2908 (1.6) |
181,875 (98.3)* 180,068 (98.4) |
Height z score Mean (SD) Male Female |
-2.38 (0.36) -2.38 (0.38) |
0.12 (0.97)* 0.07 (0.94)* |
BMI z score Median (IQR) Male Female |
-0.33 (-0.83,0.21) -0.28 (-0.69,0.21) |
0.04 (-0.54,0.75)* 0.09 (-0.45,0.80)* |
SEP cluster Median (IQR) Male Female |
2 (1,5) 3 (1,6) |
5 (2,7)* 5 (2,7)* |
Corrected birth weight Males AGA SGA LGA Females AGA SGA LGA |
2965 (91.6) 185 (5.7) 87 (2.7) 2676 (92.0) 175 (6.0) 57 (2.0) |
161,044 (88.5)* 2532 (1.4) 18,299 (10.1) 159,373 (88.5)* 2524 (1.4) 18,171 (10.1) |
* P <0.001 |
Conclusion: Understanding the origins of growth gaps and identifying possible nutritional deficits in Israeli children will help to diagnose, prevent and treat future growth impairment.