Peer-reviewed article
Predictors of short stature in Israeli children aged 6-7 years: a retrospective cohort study.
Naama Fisch-Shvalb, Michal Yackobovitch-Gavan, Naomi Fliss-Isakov, Yair Morali, Nati Brooks et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined short stature in Israeli children aged 6-7 years across different population sectors. Researchers found that short stature was most prevalent in ultraorthodox Jewish children (3.2-3.8%) and least common in Arab children (0.7-0.8%). Growth differences between sectors emerge during the first two years of life, with factors like lower birth weight and slower early growth predicting short stature at school age. The authors recommend closer monitoring of ultraorthodox children during infancy and early childhood.
Key points
- Short stature was significantly more prevalent in ultraorthodox Jewish children (3.8% boys, 3.2% girls) compared to Arab children (0.8% boys, 0.7% girls)
- Growth gaps between population sectors emerge during the first 2 years of life, not later
- Predictors of short stature at 6-7 years included lower height z-score at 2 months, birth weight below the 90th percentile, and smaller height gain until age 2
- The study included 368,088 children with anthropometric data collected from school entry health assessments during 2015-2019
- Stunting rates in Bedouin children were similar to the general population at 1.6%
Limitations
This is a retrospective study relying on existing health records, so data quality and completeness may vary. The study identifies correlations but cannot explain the underlying causes of growth differences between sectors, such as nutritional, genetic, or socioeconomic factors.
Abstract
There are differences in the rates of short stature (WHO height-z score < -2SD) between the various sectors in Israeli children aged 6-7 years, with higher rates in the ultraorthodox Jewish population. We aimed to: (a) Compare the anthropometric data at 0-2 years of age and the obstetric and demographic data of children with short stature at 6-7 years of age with those of children with normal height. (b) Assess risk factors for short stature at the age of 6-7 years. (c) Evaluate the impact of clinical and socioeconomic factors on linear growth from birth to the age of 6-7 years. This was a retrospective cohort study. Anonymized anthropometric data measured at the first grade of school during 2015-2019 were collected from the Ministry of Health records. The participants were stratified into sectors according to the affiliation of their school. Retrospective growth and sociodemographic data were extracted for each child from the national birth registry and Maternal Child Health Clinics files. The cohort included 368,088 children, with a median age of 6.7 years (IQR 6.3,7.0). Short stature was more prevalent in ultraorthodox Jewish boys (3.8%) and girls (3.2%), and least prevalent in Arab boys (0.8%) and girls (0.7%) compared with all other sectors (P < 0.001). The rate of stunting in Bedouin children was similar to that in the general population (1.6%). In a logistic regression model, the variables that predicted short stature at the age of 6-7 years were female sex, longer gestation, lower height z-score at 2 months of age, birth weight < 90th percentile, being in the ultraorthodox Jewish sector, and a smaller change in height z-score until 2 years of age. Growth gaps between different sectors of school-aged Israeli children emerge during the first 2 years of life. The most vulnerable population for stunting is the ultraorthodox population. Public health services, including Maternal Child Health clinics and primary caregivers, should prioritize this group and closely monitor for growth faltering during the first and second years of life.