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: 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 rat io (OR) and 95% 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 b oth included BMI, paternal height, maternal height, birth weight, birth height, l atter birth order (>= 2) and less parental patience to children. Besides, breastfeeding dura tion (>= 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 signific ant factors in nomograms had descent prediction accuracies, with the C-index 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 chara cteristics, nutrition status from the 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.