1 Professor of Mother and Child Health, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran

2 Assistant Professor of Pediatric Pulmonology, Department of Pediatrics, School of Medicine, Hazrat-e Ali Asghar Pediatrics Hospital, Iran University of Medical Sciences, Tehran, Iran

3 Student Research Committee, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

4 MSc in Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran.

5 MSc in Biostatistics, Department of Biostatistics and Epidemiology, Hamadan University of Medical Sciences, Urmia, Iran


Background: Children under five years of age are the primary victims of malnutrition. This study aimed to investigate risk factors of stunting among children less than 5 years in North-Western Iran.
Methods: This cross-sectional study was performed on 3300 children under 5 years of age in West Azerbaijan province. Selected households were visited by fifteen trained teams. Collected data were consisted of name, date of birth, height, weight, sex, breastfeeding status, age, stunting status (Without stunting, moderate, severe), place of residence, care quality, completion of growth curve and knowledge of mothers about heath cares. The data were analyzed using STATA version 20. Chi-square, binary logistic, and ordinal regression were used. P-values less than 0.05 were considered significant.
Results: Among 3300 children, a total of 436 individuals (13.2%) had stunting (moderate: 302 children/severe: 134 children). The Mean weight, height, BMI, month of birth and breast feeding duration in children were 11.89±3.76, 86.26±15.05, 15.88±2.44, 6.23±3.47 and 4.13±5.20, respectively. No significant independency was found among children with/without stunting regarding having breast feeding or cow milk, using baby pacifier and number of under-5-year children in each family (p>0.05). Other qualitative variables were not homogenous (p<0.05). In binary logistic regression analysis, age and weight were presented as risk factors in the model, that is, by increasing one unit of the age, provided that the other variables remain constant in the model, the risk of stunting increases for approximately four times, because the odds ratio (OR = 4.034) is significant (p = 0.021 ). Weight variable also produced such a situation (OR = 4.437, p = 0.007). Assuming that other variables remain constant in the model, the risk of shifting to the higher order of the stunting variable is roughly doubled in the model, because the odds ratio (OR = 2.285) is significant (p = 0.005).  Height was a preventive variable in the model for developing stunting (OR = 0.204, p = 0.002). In ordinal regression analysis, weight was presented as a risk factor in the model (OR = 2.285, p = 0.005) and height was a preventive variable (OR = 0.450, p = 0.001).
Conclusion: According to the results of the study, prevalence of stunting is high indicating the necessary measures in this regard. Weight, height and age are appropriate predictors to predict stunting in children