Fisch-Shvalb Naama, Yackobovitch-Gavan Michal, Fliss-Isakov Naomi, Morali Yair, Brooks Nati, Blaychfeld-Magnazi Moran, Zimmerman Deena Rachel, Lazar Liora, Phillip Moshe, Endevelt Ronit
Institute of Endocrinology and Diabetes, Schneider Children's Medical Center, Petach Tikva, Israel.
Department of Pediatrics, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr J Health Policy Res. 2025 Mar 5;14(1):11. doi: 10.1186/s13584-025-00674-8.
There are differences in the rates of short stature (WHO height-z score < -2SD) between the various sectors in Israeli children aged 6-7 years, with higher rates in the ultraorthodox Jewish population. We aimed to: (a) Compare the anthropometric data at 0-2 years of age and the obstetric and demographic data of children with short stature at 6-7 years of age with those of children with normal height. (b) Assess risk factors for short stature at the age of 6-7 years. (c) Evaluate the impact of clinical and socioeconomic factors on linear growth from birth to the age of 6-7 years. This was a retrospective cohort study. Anonymized anthropometric data measured at the first grade of school during 2015-2019 were collected from the Ministry of Health records. The participants were stratified into sectors according to the affiliation of their school. Retrospective growth and sociodemographic data were extracted for each child from the national birth registry and Maternal Child Health Clinics files. The cohort included 368,088 children, with a median age of 6.7 years (IQR 6.3,7.0). Short stature was more prevalent in ultraorthodox Jewish boys (3.8%) and girls (3.2%), and least prevalent in Arab boys (0.8%) and girls (0.7%) compared with all other sectors (P < 0.001). The rate of stunting in Bedouin children was similar to that in the general population (1.6%). In a logistic regression model, the variables that predicted short stature at the age of 6-7 years were female sex, longer gestation, lower height z-score at 2 months of age, birth weight < 90th percentile, being in the ultraorthodox Jewish sector, and a smaller change in height z-score until 2 years of age. Growth gaps between different sectors of school-aged Israeli children emerge during the first 2 years of life. The most vulnerable population for stunting is the ultraorthodox population. Public health services, including Maternal Child Health clinics and primary caregivers, should prioritize this group and closely monitor for growth faltering during the first and second years of life.
在以色列6至7岁儿童的不同群体中，身材矮小（世界卫生组织身高Z评分＜-2标准差）的发生率存在差异，极端正统犹太人群体中的发生率更高。我们的目标是：(a) 比较身材矮小的6至7岁儿童与身高正常儿童在0至2岁时的人体测量数据以及产科和人口统计学数据。(b) 评估6至7岁时身材矮小的风险因素。(c) 评估临床和社会经济因素对从出生到6至7岁线性生长的影响。这是一项回顾性队列研究。从卫生部记录中收集了2015年至2019年在小学一年级测量的匿名人体测量数据。参与者根据其学校所属群体进行分层。从国家出生登记处和母婴健康诊所档案中为每个孩子提取回顾性生长和社会人口统计学数据。该队列包括368,088名儿童，中位年龄为6.7岁（四分位间距6.3,7.0）。与所有其他群体相比，极端正统犹太男孩（3.8%）和女孩（3.2%）中身材矮小更为普遍，而阿拉伯男孩（0.8%）和女孩（0.7%）中最为少见（P＜0.001）。贝都因儿童发育迟缓的发生率与一般人群相似（1.6%）。在逻辑回归模型中，预测6至7岁时身材矮小的变量为女性性别、孕期较长、2个月大时身高Z评分较低、出生体重＜第90百分位数、属于极端正统犹太群体以及到2岁时身高Z评分变化较小。以色列学龄儿童不同群体之间的生长差距在生命的头两年出现。发育迟缓最脆弱的群体是极端正统群体。包括母婴健康诊所和主要照顾者在内的公共卫生服务应优先关注该群体，并密切监测生命第一年和第二年期间的生长迟缓情况。
