Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, QC, Canada.
Axe Santé des Populations et Pratiques Optimales en Santé, Traumatologie-Urgence-Soins intensifs, Centre de Recherche du CHU de Québec - Université Laval (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada.
Acta Paediatr. 2022 Oct;111(10):1853-1861. doi: 10.1111/apa.16449. Epub 2022 Jun 23.
To review evidence of the effects of stunting, or height-for-age, on schooling level and schooling trajectories, defined as the combination of school entry age, grade repetition and dropouts.
We conducted a systematic review of studies (last update 20 March 2021) that assessed the association between stunting, or height-for-age, and at least one component of school trajectory using five databases (PubMed, Embase, Education Resources Information Center [ERIC], Web of Science and PsycINFO). Two independent reviewers performed study selection and data extraction. Pooled effects were calculated using the generic inverse variance weighting random-effect model. The risk of bias was assessed using the ROBINS-I tool (PROSPERO ID: CRD42020198346).
We screened 3944 articles, and 16 were eligible for the qualitative and quantitative syntheses. Meta-analysis showed that an increase in height-for-age leads to an increase in early enrolment [OR = 1.34 (95% CI, 1.07-1.67)], a reduction in late enrolment [OR = 0.63 (95% CI, 0.51-0.78)], an increase in schooling level [MD = 0.24 (95% CI, 0.14-0.34)] and a reduction in school overage [OR = 0.79 (95% CI, 0.70-0.90)]. Stunted children were more likely to repeat a grade than non-stunted [OR = 1.59 (95% CI, 1.18-2.14)].
This review suggests that stunting in childhood might negatively affect school trajectories. Future research should evaluate the effect of stunting on school trajectories and the modification effect of socioeconomic status.
综述身高发育迟缓（身高年龄）对入学年龄、留级和辍学等学校轨迹组成部分的学校教育水平和轨迹的影响的证据。
我们对评估身高发育迟缓与至少一个学校轨迹组成部分之间关联的研究（最后更新日期为 2021 年 3 月 20 日）进行了系统综述，这些研究使用了五个数据库（PubMed、Embase、教育资源信息中心 [ERIC]、Web of Science 和 PsycINFO）。两名独立的审查员进行了研究选择和数据提取。使用通用倒数方差加权随机效应模型计算汇总效应。使用 ROBINS-I 工具（PROSPERO ID：CRD42020198346）评估偏倚风险。
我们筛选了 3944 篇文章，其中 16 篇文章符合定性和定量综合分析的条件。荟萃分析表明，身高发育迟缓的增加会导致早期入学率的增加[OR=1.34（95% CI，1.07-1.67）]，入学年龄延迟的减少[OR=0.63（95% CI，0.51-0.78）]，教育水平的提高[MD=0.24（95% CI，0.14-0.34）]和学龄期的减少[OR=0.79（95% CI，0.70-0.90）]。发育迟缓的儿童比非发育迟缓的儿童更有可能留级[OR=1.59（95% CI，1.18-2.14）]。
本综述表明，儿童时期的发育迟缓可能会对学校轨迹产生负面影响。未来的研究应评估发育迟缓对学校轨迹的影响，以及社会经济地位的调节作用。
