Peer-reviewed article
Facial Proportions in Stunted and Non-Stunted Children Aged 7-72 Months: A Cross-Sectional Study in Bandung, Indonesia.
Hidayat NA, Latif DS, Setiawan AS ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study measured facial dimensions in 266 children aged 7-72 months in Indonesia to understand how stunting (chronic malnutrition) affects facial growth. Stunted children had shorter vertical facial proportions (nose to chin measurements) compared to non-stunted children, while horizontal measurements showed no difference. The researchers suggest these facial measurements could help identify stunted children in community health settings using simple tools.
Key points
- Stunted children showed significantly shorter vertical facial dimensions: median 32.4 mm vs 33.6 mm (p=0.003) for upper face and 42.5 mm vs 45.1 mm (p<0.001) for lower face
- Horizontal facial dimensions (zygomatic width and intergonion width) showed no significant differences between stunted and non-stunted groups
- All facial measurements correlated positively with age (p<0.001) in both groups
- No significant differences in facial proportions were found between boys and girls
- Vertical facial proportions may be used as supportive screening indicators for stunting detection in community-based growth monitoring programs
Limitations
This is a cross-sectional study measuring associations only, not causes, so it cannot explain why stunting affects vertical facial growth or whether these measurements could actually predict stunting in practice. The study does not establish the sensitivity or specificity of facial measurements for identifying stunted children compared to standard height-for-age screening.
Abstract
Stunting is a chronic growth disorder that not only affects height but may also impair craniofacial development. Facial proportions, especially in the vertical dimension, may provide additional anthropometric insight into growth status among children. Objectives: To assess and compare the vertical and horizontal facial proportions of stunted and non-stunted children, and to explore the potential of facial dimensions as supportive indicators for early-stunting detection in community-based settings. Methods: This cross-sectional analytical study involved 266 children aged 7-72 months (mean age 42.63 ± 13.82 months) from several community health centers in Bandung, Indonesia. Children were categorized as stunted or non-stunted based on WHO height-for-age Z-scores. Facial dimensions were measured directly by calibrated pediatric dentistry residents using manual instruments. The vertical dimensions included Nasion-Subnasale (N-SN) and Subnasale-Menton (SN-M), while horizontal dimensions included zygomatic width and intergonion width. Data were analyzed using the Mann-Whitney U test and Spearman correlation. Results: Significant differences were found in vertical facial dimensions between stunted and non-stunted children: median N-SN (32.4 mm vs. 33.6 mm; p = 0.003) and SN-M (42.5 mm vs. 45.1 mm; p < 0.001). No significant differences were observed in horizontal dimensions. All facial parameters showed a positive correlation with age (p < 0.001). No significant differences were found based on sex. Conclusions: Stunted children exhibited shorter vertical facial dimensions compared to their non-stunted peers, while horizontal dimensions remained stable across groups. Vertical facial proportions may serve as supportive indicators in the screening and monitoring of childhood stunting. This method has potential for integration into community-based growth monitoring using simple or digital anthropometric tools.