Factors Affecting the Growth Impairment in Children Less than ۶ Years: A Longitudinal Study Using Transfer and Marginal Transfer Models

Background: Childhood has coincided with a rapid growth and development and growth impairment (GI) of this period lead to lifelong problems. Thus, this study aimed to evaluate the factors affecting the growth impairment of children under ۶ years of age in West Azerbaijan Province, Iran.Methods: This prospective-longitudinal study was conducted on ۱۰۷۰ neonates from the cities and urban health centers in the West Azerbaijan province, Iran. Studied neonates were randomly selected in a two-stage cluster sampling. During a ۶-year follow-up, children’s characteristics of growth (height, weight) and development (walking, speaking and teething age) were measured and recorded. Data were collected by R statistical software and analyzed by using the transfer and marginal transfer models.Results: The results of the models' fitting showed that the main effect of the maternal educational level [elementary (p = ۰.۰۰۷) and high school (p = ۰.۰۰۳)], child's gender (p <۰.۰۰۱), child’s health care (p <۰.۰۰۱), the first age of the teething (p =۰.۰۳۱) and walking (p =۰.۰۲۱) had significant effect on GI.Conclusion: The research results showed that with increasing the age of teething, the odds ratio of the GI decreases. Also, every one-month increase in walking age was associated with decreasing odds ratio of GI. Moreover, the present study revealed that some demographic factors have a significant effect on children's GI. Early detection of the factors affecting child GI and primary prevention of its adverse effects is recommended.

Keywords:

Child growth impairment , growth and development , transfer model , marginal transfer model