DETERMINANTS OF SHORT STATURE IN CHILDREN WITH TRANSFUSION-DEPENDENT THALASSEMIA: A CROSS-SECTIONAL STUDY IN INDONESIA

Abstract

Repeated transfusion complications and malnutrition significantly contribute to the high short stature prevalence in children with thalassemia. This study analyzed the prevalence and determinants of short stature in children with transfusion-dependent thalassemia. This cross sectional observational study involved 120 pediatric patients (aged 24–216 months) at Dr. Cipto Mangunkusumo Hospital, Jakarta (August–December 2023) via consecutive sampling. Nutritional status was assessed using height and mid-upper arm circumference (MUAC) based on WHO Z-scores, alongside medical record extraction for pre-transfusion hemoglobin and serum ferritin. Data analysis utilized Chi-square and multivariate logistic regression (p < 0.05). Of 120 subjects (54.2% male), short stature prevalence was 39.2 percent and malnutrition 56.7 percent. Three independent determinants significantly associated with short stature were malnutrition based on MUAC (OR=5.02; 95% CI: 1.88–13.44; p=0.001), transfusion frequency ≥2 weeks (OR=3.59; 95% CI: 1.40–9.21; p=0.008), and serum ferritin ≥3500 µg/L (OR=3.55; 95% CI: 1.22–10.34; p=0.020). In conclusion, malnutrition, high transfusion frequency, and iron overload are the main determinants of short stature. Clinical management must prioritize routine nutritional screening via MUAC, strict iron chelation monitoring, and integrating nutritional interventions into national protocols to prevent growth morbidity.