Original Article

Effective Factors on the Rate of Growth Failure in Children Below Two Years of Age: A Recurrent Events Model

Abstract

Background: Growth failure, constituting one the health problems in children below 2 yr of age, can lead to major complications such as death or mental, emotional and physical disabilities. The present study aimed to investigate effective factors on growth failure in the height and weight of less than 2 yr old children of Khorramabad, Iran in 2013.

Methods: This present longitudinal retrospective study used stratified and clustered sampling. Based on growth curves in family records, the incidence times of growth failure in height and weight of each child were recorded. In the next stage, using recurrent events model (proportional rate model), along with SAS software (version 9.2), the data were modeled.

Results: According to proportional rate model, the effect of mothers’ educational level on the rate of growth failure in the height and weight of children was significant (P=0.046, P=0.049) and the effect of fathers’ job was significant only on growth failure in children’s weight (P<0.001). However, the effect of other variables, including gender, birth order and exclusive breastfeeding status on children’s growth failure rate was not significant.

Conclusion: Enhancing mother’s awareness in low-income families, in tandem with changing educated mothers’ attitude towards the required skills and guiding principles for feeding children below 2 yr of age, can be conceived of as the most important approach in dealing with growth failure of children.

 

 

Onyiriuka AN (2011). Evaluation and Management of the Child with Failure to Thrive. Hosp Chron, 6(1): 9–23.

Wright CM, Loughridge J, Moore G (2000). Failure to thrive in a population context: Two contrasting studies of feeding and nutritional status. Proc Nutr Soc, 59(1): 37-45.

Fatholahpour A, Miraki KH (2002). A survey of the growth curve, mean height and weight in children younger than 3 years old in Sanandaj. Scientific Journal of Kurdistan University of Medical Sciences, 6(2): 29-35. (In Persian)

Hendaus M, Al-Hammadi A (2013). Failure to thrive in infants (review). Georgian Med News, (214): 48-54.

Berak M, Azari Namin L, Nemati A et al (2004). Risk factor of failure to thrive in less than 2 years old children Namin. Research Scientific Journal of Ardabil University of Medical Sciences and Health Services, 10:13-17. (In Persian)

Naderi S (2003). Growth indices of 2-5 years old infants in Bandar Abbas day-care centers. Medical Journal of Hormozgan University, 6(4): 31- 35. (In Persian)

Toutounchi P (2009). The weight to age growth chart in 5 years old children and its risk factors in Tehran, Iran. Payesh, 8(1): 67-73. (In Persian)

Reyhani T, Ajam M (2000). The comparative study of the children growth curve of 0-6 months using formula and breastfeeding in Gonabad city. Ofogh-e-Danesh, 6(1): 49-55. (In Persian)

World Health Organization (1986). The growth chart: a tool for use in infant and child health care. Ginebra: Organización Mundial de la Salud. http://apps.who.int/iris/bitstream/10665/40502/1/924154208X-eng.pdf

Sheykholeslam R, Naghavi M, Abd Elahi Z et al (2008). Current status and the 10 years trend in the malnutrition indexes of children under 5 years in Iran. Iran J Epidemiology, 4(1): 21-28. (In Persian)

Heydari S.T, Emam Ghoreyshi F, Amini M (2005). A comparative study on growth state of children less than two-years old in Jahrom, southeastern Iran with NCHS measurements. Ofogh-e-Danesh, 11(3): 42- 48. (In Persian)

Kholdi N, Ramezankhani A, Zaeri F, Jafari F, Davati A (2010). Risk factors of underweight in less than 2 years old children in Tehran. Research Scientific Journal of Shahid Beheshti University; 75: 104-110. (In Persian)

Becker S, Black RE, Brown KH (1991). Relative effects of diarrhea, fever, and dietary intake on weight gain in rural Bangladeshi children. Am J Clin Nutr, 53(6): 1499-503.

Saki Malehi A, Hajizadeh E, Ahmadi K, Kholdi N (2014). Modeling the recurrent failure to thrive in less than two-year children: recurrent events survival analysis. J Res Health Sci, 14(1): 96-9.

Cook RJ, Lawless JF (2007). The statistical analysis of recurrent events. Springer: New York. pp: 11-14.

Kleinbaum DG, Klein M (2012). Survival Analysis: A Self-Learning Text. 3rd Ed. Springer: New York. pp: 603-607.

Vahabi N, Salehi M, Azarbar A et al (2014). Application of multilevel model for assessing the affected factors on failure to thrive in children less than two years old. Razi Journal of Medical Sciences, 21(124): 91-99. (In Persian)

Gohari MR, Salehi M, Zayeri F et al (2012). Application of random effect model for determining factors affecting FTT in less than 2 years children in east of Tehran. Razi Journal of Medical Sciences, 19(99): 33-39. (In Persian)

Kholdi N, Ramezankhani A, Zayeri F et al (2011). Weight loss and affected factors in less than 2 years children. Pajuhandeh,75(3): 104-110. (In Persian)

Chopra M (2003). Risk factors for undernutrition of young children in a rural area of South Africa. Public Health Nutr, 6(7): 645-52.

Horta BL, Bahl R, Martines JC, Victora CG (2007). Evidence on the long-term effects of breastfeeding: systematic reviews and meta-analyses. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/10665/43623/1/9789241595230_eng.pdf

Bloss E, Wainaina F, Bailey RC (2004). Prevalence and predictors of underweight, stunting and wasting among children aged 5 and under in western Kenya. J Trop Pediatr, 50(5): 260-70.

Bazmazmoon H (2002). Weight gain in 0-24 months old children attending to Kaboodrahang health centers 1998. Scientific Journal of Hamadan University of Medical Sciences, 9(4): 61-64. (In Persian)

Ehsanpour S, Bashardoust N, Moshref S (1994). Important factor on weight gain in less than 2 years old children under median (of weight), Isfahan. Research on Medical Sciences, 2: 134-139. (In Persian)

Vahidi AS, Daee Parizi MH, Kazemian M (1993). Nutritional status and associated factors in children aged 4/5-9 months in Kerman, Iran. JKUMS, 8: 164-170. (In Persian)

Abadi A, Rahimi G, Mehrabi Y, Kholdi N (2012). Estimating the month-specific effect of complementary food on weight loss occurrence rate in less than 2 years old children. Koomesh, 14(1): 1-6. (In Persian).

Files
IssueVol 47 No 3 (2018) QRcode
SectionOriginal Article(s)
Keywords
Growth failure Children Survival analysis Recurrent events model Proportional rate model

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
EBRAHIMZADEH F, HAJIZADEH E, BAGHESTANI AR, NAZER MR. Effective Factors on the Rate of Growth Failure in Children Below Two Years of Age: A Recurrent Events Model. Iran J Public Health. 2018;47(3):418-426.