Risk factors of stunting in Indonesian children aged 1 to 60 months

Background The Indonesian province of Aceh has a high prevalence of stunting. Identifying risk factors for stunting may help prevention efforts. The Growth Diagrams o f Indonesian Children are a specific tool to diagnose stunting in Indonesian pediatric populations. Objective To determine the risk factors of stunting in children aged 1.60 months using the Growth Diagrams o f Indonesian Children. Methods This observational, analytic study with case-control design was conducted in the Lawe Alas District, Southeast Aceh, Indonesia to compare prior risk factors exposure between stunted children (cases) and non-stunted children (controls) from January-April 2018. Subjects were children aged 1.60 months and recruited by consecutive sampling. Results The subjects comprised 97 cases and 97 controls, totaling 194 subjects, internal risk factors of stunting were short birth length (OR 2.87; 95%CI 1.24 to 6.61; P=0.011), inadequate calorie intake (OR 2.37; 95%CI 1.32 to 4.27; P=0.004), non-exclusive breastfeeding (OR 3.64; 95%CI 2.01 to 6.61; P<0.001), chronic diarrhea (OR 6.56; 95%CI 3.33 to 13.01; P<0.001) and upper respiratory tract infections (OR 3.47; 95%CI 1.89 to 6.35; P<0.001). External risk factors of stunting were unimproved sanitation (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), unimproved water sources (OR 2.71; 95%CI 1.50 to 4.88; P=0.001), low family income (OR 2.49; 95%CI 1.38 to 4.49; P=0.002), low paternal educational level (OR 2.98; 95%CI 1.62 to 5.48; P < 0.001), low maternal educational level (OR 2.64; 95%CI 1.38 to 5.04; P=0.003), and living in households with >4 family members (OR 1.23; 95%Cl 0.69 to 2.17; P=0.469). Regression analysis showed that the dominant risk factor of stunting was chronic diarrhea (OR 5.41; 95%CI 2.20 to 13.29; P<0.001). Conclusion The history of chronic diarrhea and nonexclusive breastfeeding are the main risk factors of childhood stunting.