Tesis

KESESUAIAN BERBAGAI KURVA PERTUMBUHAN DAN PERHITUNGAN TINGGI BADAN DALAM PENENTUAN PERAWAKAN PENDEK DAN KEJAR TUMBUH PADA ANAK USIA SEKOLAH = COMPATIBILITY OF VARIOUS GROWTH CHARTS AND HEIGHT MEASUREMENT IN DETERMINING SHORT STATURE AND CATCH-UP GROWTH IN SCHOOL-AGE CHILDREN

Latar belakang: Pada anak usia sekolah, pertumbuhan linier ditentukan berdasarkan kriteria kurva pertumbuhan WHO/2007 dan CDC/2000 serta persentase tinggi badan menurut Waterlow/1977. Perbedaan kriteria yang digunakan akan menimbulkan perbedaan prevalens perawakan pendek. Penentuan kejar tumbuh anak juga masih mengalami perdebatan karena parameter kejar tumbuh dapat dinilai secara relatif (heightage z-score) dan absolut (height-age-differences). Kejar tumbuh linier yang terutama terjadi dalam 1000 hari pertama kehidupan dinilai dapat terus terjadi hingga usia sekolah. Metode: Studi potong lintang dilakukan pada 302 anak usia sekolah di Jakarta Barat. Semua anak diukur tinggi badan sewaktu penelitian dan saat subyek berusia 7 tahun. Perawakan pendek ditentukan dengan menggunakan kriteria WHO/2007, CDC/2000, dan persentase tinggi badan menurut Waterlow/1977. Setiap kelompok usia diukur perbedaan nilai height-age z-score (HAZ) dan height-age-differences (HAD) dalam dua waktu pengukuran yang berbeda untuk melihat kejar tumbuh. Hasil: Prevalens perawakan pendek pada anak usia sekolah berdasarkan kriteria WHO/2007 adalah 8,55%, berdasarkan CDC/2000 sebesar 13,75%, dan berdasarkan Waterlow/1977 sebesar 7,80%. Nilai Kappa WHO/2007 dan CDC/2000 adalah 0,5, WHO/2007 dan Waterlow/1977 adalah 0,8, sedangkan CDC/2000 dan Waterlow/1977 adalah 0,7. Nilai HAZ anak perempuan adalah -1,78 SD dan anak lelaki -1,44 SD. Nilai HAD anak perempuan adalah -10,83 cm untuk anak lelaki adalah -8,83 cm. Kesimpulan: Kesesuaian perawakan pendek anak WHO/2007 dan CDC/2000 memberikan hasil yang sama sebanyak 50%, WHO/2007 dan Waterlow/1977 memberikan hasil yang sama sebanyak 80%, sedangkan CDC/2000 dan Waterlow/1977 memberikan hasil yang sama sebanyak 70%. Kesan terdapat kejar tumbuh pada anak usia sekolah di Jakarta Barat berdasarkan adanya perbaikan nilai HAZ dan HAD pada pengukuran kedua dibandingkan dengan pengukuran pertama.
Kata kunci: kejar tumbuh, perawakan pendek, height-age z-score, height-age-difference


Background: Linear growth in school children is determined by using WHO/2007 and CDC/2000 growth chart, also height-age persentage as Waterlow/1977 criteria. Those classification resulted in different prevalence of short stature. Linear catch-up growth is considered to continue beyond the first thousand days of life, at least until school age. It could be relatively (height-age z score) or absolutely (height-age difference) assessed. Methods: A cross-sectional study was conducted in 302 school age children in West Jakarta. Body height was measured at 7 years old and at the time of study. Short stature was defined by using WHO/2007, CDC/2000, and height-age persentage as Waterlow/1977 criteria. Height-age z score (HAZ) and height age differences (HAD) was measured in each group to assess catch-up growth. Results: The prevalence of short stature in school children was 8.55%, 13.75%, and 7.80%, according to WHO/2007, CDC/2000, and height-age persentage as Waterlow/1977 criteria, respectively. Kappa values were 0.5, 0.8, and 0.7, between WHO/2007-CDC/2000, WHO/2007-Waterlow/1977, and CDC/2000-Waterlow/1977, respectively. HAZ was -1.78 and -1.44 SD in female and male subjects, respectively. HAD was -10.83 and -8.83 cm in female and male subjects, respectively. Conclusion: WHO/2007 and Waterlow/1977 has the highest agreement, while WHO/2007 and CDC/2007 has the lowest agreement. Linear catch-up growth was observed among our subjects as determined by HAZ and HAD improvement compared to the first measurement.
Keywords: linear growth, catch-up growth, short stature, height-age z-score, height-agedifference