Growth Patterns and Factors Associated with Early Childhood Growth in Sumbawa, Indonesia

Abstract

Population-specific growth references have been established in several populations, but evidence from Indonesian children remains limited. This study characterized growth patterns among children from Sumbawa, compared them with national growth references, evaluated differences in nutritional status classification, and examined factors associated with child growth. A cross-sectional study was conducted among 207 children aged 0–5 years from two villages in Sumbawa, Indonesia. Anthropometric and sociodemographic data were collected using standardized procedures and structured questionnaires. Growth curves were modeled using GAMLSS and compared with the Indonesian national growth reference. Nutritional status was assessed using population-specific, Indonesian, and WHO growth references. Factors associated with height-for-age (HAZ), weight-for-age (WAZ), and BMI-for-age (BMIZ) z-scores were examined using generalized linear models. Body height and weight increased progressively with age, whereas BMI gradually declined throughout early childhood. Compared with the INSGC (Indonesia Synthetic Growth Chart), the median (P50) height, weight, and BMI values of Sumbawa children were lower across most ages. Nutritional status classifications differed substantially across growth references, with the WHO Child Growth Standards and Permenkes classifying higher proportions of children as stunted, underweight, and wasted/overweight than the population-specific reference. Maternal age at childbirth and household sanitation score were positively associated with HAZ, whereas the number of older siblings was negatively associated with BMIZ. Children from Sumbawa exhibited population-specific growth pattern that differed from the Indonesian national reference, highlighting the importance of considering population-specific growth references when interpreting child growth and nutritional status.