Facial Proportions in Stunted and Non-Stunted Children Aged 7-72 Months: A Cross-Sectional Study in Bandung, Indonesia

印度尼西亚万隆市一项横断面研究:7-72个月龄发育迟缓和非发育迟缓儿童面部比例的比较

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Abstract

Stunting is a chronic growth disorder that not only affects height but may also impair craniofacial development. Facial proportions, especially in the vertical dimension, may provide additional anthropometric insight into growth status among children. Objectives: To assess and compare the vertical and horizontal facial proportions of stunted and non-stunted children, and to explore the potential of facial dimensions as supportive indicators for early-stunting detection in community-based settings. Methods: This cross-sectional analytical study involved 266 children aged 7-72 months (mean age 42.63 ± 13.82 months) from several community health centers in Bandung, Indonesia. Children were categorized as stunted or non-stunted based on WHO height-for-age Z-scores. Facial dimensions were measured directly by calibrated pediatric dentistry residents using manual instruments. The vertical dimensions included Nasion-Subnasale (N-SN) and Subnasale-Menton (SN-M), while horizontal dimensions included zygomatic width and intergonion width. Data were analyzed using the Mann-Whitney U test and Spearman correlation. Results: Significant differences were found in vertical facial dimensions between stunted and non-stunted children: median N-SN (32.4 mm vs. 33.6 mm; p = 0.003) and SN-M (42.5 mm vs. 45.1 mm; p < 0.001). No significant differences were observed in horizontal dimensions. All facial parameters showed a positive correlation with age (p < 0.001). No significant differences were found based on sex. Conclusions: Stunted children exhibited shorter vertical facial dimensions compared to their non-stunted peers, while horizontal dimensions remained stable across groups. Vertical facial proportions may serve as supportive indicators in the screening and monitoring of childhood stunting. This method has potential for integration into community-based growth monitoring using simple or digital anthropometric tools.

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