Determination of factors affecting growth failure of children under two years with multilevel logistic regression model

Background and Objective: Growth failure is one of the important health issues around the world especially in developing countries such as Iran that results in inability to growth over time. The aim of this research was to detect some of the most effective factors of growth failure in children under two years using the multilevel logistic regression model.

Materials & Methods: In this longitudinal study, using a cluster sampling method, 2182 children less than two years were randomly selected from eight health centers in Tehran. Growth failure was defined as a weight decrease in a child weight (minimum 50 grams) at each attendance related to the previous evaluation. To identify the effective factors, the three-level logistic regression model was fitted.

Results: In three-level logistic regression model, fever (p = 0.299), breast-feeding during 2 hours after birth (p = 0.787) and age of beginning complementary food (p = 0.165) were not significant, but teething, diarrhea, catching cold, urinary tract infections, and discontinuation of breast-feeding were the significant risk indicators for FTT (p < 0.001). The variance of the 3rd level (health centers) was 0.78 (SE = 0.46) and the variance of the 2nd level (infants) was estimated 0.54 (SE = 0.09).

Conclusion: In general, our findings showed a rather high prevalence of growth failure in our study population (54.2% of infants experienced growth failure during the first 24 months of their life). Therefore, considering the significant risk factors in the incidence of FTT in children between 0 and 2 years in Tehran, it seems the promotion of knowledge level of mothers and healthcare providers may reduce and control this problem effectively.