Prevalence and Aetiological Profile of Short Stature in School Children between 6-11 Years of Age- A Community Based Prospective Observational Study

Abstract

Introduction: Growth is a complex process and influenced by genetic back ground, different functions of endocrine system, nutrition, effect of any chronic disease and the level of individual physical activity. Regular height measurement is one of the methods to evaluate growth. Short stature might be the first sign of various pathological conditions. Early recognition of short stature allows early intervention optimising the possibility of achieving good health and normal adult height. Community based studies utilising standard protocols are less from India as many studies are limited to children visiting tertiary care centre with complaints of short stature. Aim: The present study aimed to assess the prevalence and aetiological profile of short stature in urban school children of Bangalore. Materials and Methods: This prospective observational study was conducted among five schools in Devarajevanahalli, Bangalore from November 2015 to January 2017. Written informed consent was taken from the principal. Children from 6-11 years were recruited into this study till the sample size was reached. Total of 1128 children were chosen for the study. Anthropometric measurements like height, weight, Body Mass Index (BMI) was done. Height was plotted in Indian Academy of Pediatrics (IAP) growth charts. Those with height <3rd centile were considered of short stature. Children with short stature were followed after one year to see for height velocity. Children with height velocity of <25th centile were evaluated. Detailed history focussing on nutrition and complete physical examination, relevant investigations were done. The cause of short stature in them was assessed and grouped into physiological and pathological short stature. Continuous variables like height, weight, BMI were presented as mean [standard deviation (SD)] and were compared using unpaired t-test. Categorical variable like gender, height velocity were expressed as actual numbers and percentages and association was done using Chi-square test. Height between age categories among boys and girls was compared using ANOVA test. Results: Out of 1128 school children, 62 were found to be short. The prevalence of short stature was 5.50%. Among 62 children, 31 children remained short after one year. Out of 31, only 22 children were investigated as remaining were not willing for investigations. Out of 22 children, pathological short stature was found in 13 (59.1%) and physiological short stature in nine (40.9%). In pathological short stature, chronic malnutrition with Iron Deficiency Anaemia (IDA) is in 10 (45.5%). Hypothyroidism, idiopathic short stature, uncontrolled asthma was seen in one each (4.5%). In physiological short stature, familial short stature was found in six (27.3%) and constitutional delay of growth and puberty in three (13.6%). Conclusion: Overall prevalence of short stature was 5.50% and it represents a significant percentage of our society which needs proper attention. Chronic malnutrition with IDA was most common cause of short stature in this study. As significant percentage of children had treatable causes, growth monitoring with standard growth charts should be mandatory in all schools.