Identification and characterization of factors associated with short stature and pre-shortness in Chinese preschool-aged children.

OBJECTIVES We aimed to identify and characterize potential factors, both individually and jointly as a nomogram, associated with short stature and pre-shortness in Chinese preschool-aged children. METHODS A total of 9501 children aged 3-6 years were recruited from 30 kindergartens in Beijing and Tangshan from September to December 2020 using a stratified random sampling method. Effect-size estimates are expressed as odds ratio (OR) and 95% confidence interval (CI). RESULTS The prevalence of short stature and pre-shortness in preschool-aged children was 3.9% (n=375) and 13.1% (n=1616), respectively. Factors simultaneously associated with the significant risk for short stature, pre-shortness and both included body mass index, parental height, maternal height, birthweight, birth height, latter birth order (≥2) and less parental patience to children. Besides, breastfeeding duration (≥12 months) was exclusively associated with pre-shortness (OR, 95% CI, P: 1.16, 1.01 to 1.33, 0.037), and childhood obesity with both short stature (3.45, 2.62 to 4.54, <0.001) and short stature/pre-shortness (1.37, 1.15 to 1.64, <0.001). Modeling of significant factors in nomograms had descent prediction accuracies, with the C-index of being 77.0%, 70.1% and 71.2% for short stature, pre-shortness and both, respectively (all P<0.001). CONCLUSIONS Our findings indicate the joint contribution of inherited characteristics, nutrition status from uterus to childhood, and family psychological environment to short stature and pre-shortness in Chinese preschool-aged children. Further validation in other independent groups is warranted.