Delayed skeletal maturation is a major contributor to child height deficits in a low-income setting

Background Studying the extent to which delayed skeletal maturation may contribute to childhood height deficits is important for assessing potential for recovery in heights.Aim To investigate the discrepancy in height-for-age Z-scores (HAZ) based on chronological age (HAZ-CA) compared to bone age (H...

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Main Authors: Liina Mansukoski, Barry Bogin, J. Andres Galvez-Sobral, Luis Furlán, William Johnson
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Human Biology
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Online Access:https://www.tandfonline.com/doi/10.1080/03014460.2025.2510499
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Summary:Background Studying the extent to which delayed skeletal maturation may contribute to childhood height deficits is important for assessing potential for recovery in heights.Aim To investigate the discrepancy in height-for-age Z-scores (HAZ) based on chronological age (HAZ-CA) compared to bone age (HAZ-BA) and estimate proportion of HAZ deficits attributable to delayed maturation in both sexes.Subjects and methods Using the WHO Growth References, HAZ-CA and HAZ-BA were calculated for Guatemala City children aged 6–8.99 years participating in the Universidad del Valle de Guatemala Longitudinal Study and attending a low or a very low SEP study school. A mixed effects model was developed to describe 1638 HAZ observations (Level 1) in 1107 children (Level 2) by HAZ-type, with interaction terms for HAZ-type by age, sex, school, and birth year.Results On average, skeletal age was delayed by 1.1 (SD 1.0) years. Mean HAZ-CA was −1.7 (0.9) and HAZ-BA −0.6 (0.9). Greater proportions of the total height deficit were attributable to delayed skeletal maturation in males (60-87%) versus females (49–63%), and at low- (58–87%) versus very low-SES school (49–71%).Conclusion Delayed maturation contributes to height deficits, supporting the idea that opportunity for catch-up growth continues past early childhood in both sexes.
ISSN:0301-4460
1464-5033