Stunting in hospitalized children: Prevalence and modifiable nutritional risk factors at a tertiary care hospital

Abstract

Objectives: To determine the prevalence of stunting and identify its associated factors among hospitalized children

Methodology: This descriptive cross-sectional single center study was carried out at Peads “B” Unit Khyber Teaching Hospital Peshawar from February 2020 to December 2024. A sample of 760 children between six and 60 months admitted in medical pediatric wards was enrolled in the study. Structured caregiver interviews, review of hospital records and standardized anthropometry measurements were used to collect data. Height-for-age z-scores were calculated using WHO Anthro software. Logistic regression was used to identify independent predictors of stunting.

Results: Among 760 hospitalized children, the mean age was 28.3 ± 13.7 months, and 56.8% were male. The prevalence of stunting was 35.9% (95% CI: 32.5%–39.3%), including 24.7% with moderate stunting and 11.2% with severe stunting. Independent risk factors for stunting included exclusive breastfeeding for less than six months (AOR = 1.84, 95% CI: 1.32–2.55; p = 0.001), untimely complementary feeding (AOR = 1.98, 95% CI: 1.45–2.72; p < 0.001), no zinc supplementation (AOR = 1.67, 95% CI: 1.19–2.34; p = 0.003), feeding difficulties (AOR = 2.31, 95% CI: 1.62–3.30; p < 0.001), hospital stay of more than seven days (AOR = 1.74, 95% CI: 1.24–2.42; p = 0.001), and no feeding support during hospitalization (AOR = 1.85, 95% CI: 1.34–2.55; p < 0.001).

Conclusion: Stunting is still high among hospitalized children and is strongly associated with the modifiable nutritional and in-patient care practices. Routine feeding evaluation, intervention and parental education should be included in pediatric protocols for the prevention of this serious and often unrecognized complication.