Analysis Of Etiology And Influence Factors Of Children's Short Stature

Background: Short stature refers to those children who under the same conditions are lower than those with the same race,the same region,the same sex,the same age by 2 more standard deviation,or lower than the normal growth curve of the third child.With the gradual improvement of living standards,the average height of children also increased,the family and the community's expectations of height are elevated as well.Children with short stature now have become one of the main visiting crowds of children's Growth and Development outpatient.Children's short stature may be an important negative factor affecting their adult health and social development.This short state can not only affect the physical development of children,but also have a serious impact on the child's psychology,mainly for children's Lack of self-confidence,introverted,differences of social skills compared with normal peers,and some may affect the children's education level,employment and marriage and other aspects.In addition,the short stature of children is likely to be a process of cycle.If the mother in childhood experienced a short state,then her descendants are also prone to be short stature.Forming a intergenerational cycle of poverty and the decrease of human capital which is difficult to break.Currently,there are plenty of concerns about the short stature of children worldwide.Although the number of short stature children in Asia has declined considerably in the past 10 to 20 years,there is still the largest number of short-lived children in the world.In view of the fact that the reasons of vast majority of children who are short stature are unclear,the corresponding effective intervention to promotethe healthy growth of children is untargeted.Therefore,it is of great significance to study the etiology and influence factors of children's short stature.Objectives: 1.The etiological analysis of 197 children's short stature cases in outpatient,to understand the different distribution of different causes of short children.2.A combinational application of descriptive and analytical studies,to analyze the influence factors of outpatients and the outpatients with no obvious causes in the crowds.Methods: 1.Source of data:(1)From June 2016 to February 2017,there were 197 cases of short stature children aged from 0 to 18 years old,including 98 boys and 99 girls,in the Children's Growth and Development Department of the Capital Pediatric Institute.(2)A multidimensional stratified cluster random sampling method was used to investigate the occurrence of short stature of 16091 children under 7 years old in three districts(Dongcheng District,Fengtai District and Miyun District),and 83 cases normal Healthy short stature children from 0 to 7 years old were selected as a case group.According to the principles of the same sex,the same age and the similar weight,using a 1: 1 matching method,the normal height and healthy Children in the same survey area were selected and matched to the control group.There were 83 pairs totally.2.Survey method:(1)Descriptive study of outpatient: physical examination,laboratory examination and other special examination of 0 to 18 years old children were conducted for those who have come to the children's Growth and Development outpatient for treatment.Identify the etiology according to clinical diagnosis and did the statistics about the prevalence rate of different reasons.A self-made questionnaire was used to conduct aretrospective survey on short children who did not have a clear cause.Next,the statistics were given about the time of children short stature occurred and to describe the distribution of various suspected risk factors in short children.(2)Case-control study in Beijing: Using the same questionnaire as the outpatient survey,the children in the case group and the control group were investigated.Got the time of children in the case group beginning the short stature and the distribution of various dangerous risk factors in the two groups of people in Beijing.Proposed suspicious causes were raised further and to use the method of univariate analysis to test,then got the preliminary conclusions.Results: 1.Analysis of the causes of short stature in children Of the 197 outpatients,the top three causes were children of nanosoma essentialis,short stature caused by intrauterine growth retardation and familial short stature,which accounting for 53.1%,24.4% and 10.8% of all short stature children respectively.Short stature children caused by endocrine disease accounted for 6.6%,Turner syndrome and 21-trisomy syndrome and other genetic and metabolic diseases induced short stature children accounted for only 4.7%.Among the 83 children with normal health condition in Beijing,65.9% of the children were nanosoma essentialis,23.9% had short stature due to intrauterine growth retardation,and 10.2% were children with familial shortness.2.The age of high incidence of short stature Among the short children in outpatient,30.7% of children started a short stature before 6 months of age,32.3% of children aged between 6 and 24 months,and 81.9% of children started short before the age of 3 years.In the case of children in Beijing,children who started a short stature before 6 months accounted for 23.4% of the population,45.5% of the population aged 6 to 24 months,and the proportion of the short stature occurred before the age of 3 accounted for 88.3%.3.Analysis of the influence factors of short stature of children There were 65.5% of children who had different degrees of early feeding problems,28.3% of children had varying degrees of disease history,and only 28.3% of short children did not posses any abnormalities.The further results of univariate analysis in Beijing showed that children who owned a short stature family history(OR = 3.223),intrauterine growth retardation(OR = 2.217)at birth,occurrence of asphyxia at birth,abnormal occurrence of umbilical cord around neck and so on(OR =4.357),existence of early feeding difficulties(OR=2.063),inappetence(OR=8.143),experience of two main food ever day before 3 years old(OR=13.000),dislike for meat(OR = 4.716)and eggs(OR = 6.125)and other food rich in protein children had a high risk of short stature in the future.Conclusions: 1.There is no significant cause of the short children accounted for the vast majority of the short children,of which intrauterine growth retardation induced short stature accounts for about 20% of all the short children,and familial short about 10%.The risk of these children to take a short stature will be 2 to 3 times of other children.2.0 to 3 year-old which is the state of high incidence of children short stature,should be closely monitored about children's physical growth.3.The existence of different degrees of early feeding problems in children will cause higher risk of short stature and the feeding situation of infants and young children is an important factor affecting the occurrence of short stature.