Growth Retardation In Children Research Articles

TUMOR NECROSIS FACTOR-Α AND INTERLEUKIN-6 IN BLOOD SERUM OF INFANTS AND CHILDREN WITH CONGENITAL HEART DISEASES

The aim of the study was to evaluate the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in infants and children with congenital heart defects (CHD) in comparison with the levels in the control groups. Materials and methods. The volume study included 56 patients, including 35 cyanotic and 21 cyanotic with congenital heart disease, as well as 20 control subjects. We used a specific immunoassay to measure serum ghrelin, TNF-a and IL-6 levels. All patients' cardiac diagnoses were based on clinical examination, laboratory tests, electrocardiography and echocardiography; and none of the patients had pulmonary hypertension. The body mass index (BMI) was calculated as the ratio of body weight (kg) and height squared (m). The study also included 20 healthy infants and children corresponding to age and gender as a control group. Informed consent was obtained from the parents. Results. The results of the analysis indicate a significant increase in IL-6 and TNF-a levels in cyanotic and acyanotic patients with congenital heart defects compared with the control group (P < 0.0001). The findings highlight the importance of cytokines in the pathophysiology of congenital heart defects and their effect on patient growth. It is suggested that elevated levels of IL-6 and TNF-a may stimulate the process of apoptosis, which may play a key role in growth retardation. These data indicate the presence of growth disorders in a significant proportion of patients with congenital heart defects. These results provide additional details about the nature of growth disorders in patients with congenital heart defects and highlight the importance of further research to better understand the molecular and immunological mechanisms associated with this condition. Conclusion. The findings of this study support the hypothesis of the effect of cytokines on growth in congenital heart defects. Elevated levels of IL-6 and TNF-a are likely associated with chronic congestive heart failure and hypoxia. Further research is needed to confirm these results and develop therapeutic strategies for managing growth retardation in children with congenital heart defects.

Bitterballen Formulation of Chicken Meat, Sorghum Flour, and Green Spinach as an Alternative Additional Feeding For Stunted Toddlers Age 12-23 Months

Lack of nutrition in children and stunting may be caused by several interrelated factors. One of the factors that can influence the emergence of growth retardation in children under five is a lack of food intake such as protein, energy, and zinc children failing to grow. This research analyzes the nutritional values, organoleptic quality, and best level of treatment for Bitterballen with a formulation of chicken meat, sorghum flour, and green spinach as an alternative for providing additional food to stunted toddlers aged 12-23 months. The approach used is quantitative and qualitative by analyzing the organoleptic quality results of Bitterballen, determining the best formulation treatment, and calculating the nutritional value using the yield factor and retention factor for each treatment. The manufacturing procedure was first carried out by formulating three treatments with a ratio of chicken meat, sorghum flour, and green spinach. Of all the treatments, treatment 1 had the highest acceptability, namely containing 287.86 kcal of energy with a nutritional value of 12.71 grams of protein, 17.93 grams of fat, and 19.48 grams of carbohydrates. The organoleptic quality produced by T1 is that it has a light brown color, the aroma is savory, not fishy, and not rancid, the taste produced by T1 is savory and not unpleasant, with the inner texture produced by T1 is not gritty and the outer part is crunchy. The aftertaste is savory and slightly gritty.

Household Food Security and Stunting of Under-Five Children in Indonesia: A Systematic Review

Inadequate access to food at home contributes to growth retardation in childhood. Under-five children who suffer from stunting have problems in their growth and development owing to a lack of nutrients over an extended period of time. This study aimed to analyzed the relationship between household food security and stunting prevalence. This study uses a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Seven electronic databases are used: PubMed, ProQuest, MDPI, Science Direct, Scopus, Google Scholar, and Portal Garuda. This research was based on studies conducted in Indonesia and published between 2013 and 2023. For the final result, sixteen articles were included. Household food security has a positive correlation with the stunting of under-five children in Indonesia. Moreover, households with food insecurity had a greater risk of stunting. A household is said to be food-secure when access to food is fulfilled by all family members. From this systematic review, the government is expected to formulate policies and strategies to improve household food security and the nutritional status of children under the age of five. To accomplish these efforts, coordination between sectors is required to accelerate and strengthen the implementation of these policies and strategies.

Health Indicators for Accelerating Stunting Reduction: Family Practices in Indonesian Borderland

Background: The Indonesian government has established the latest family-based approach to implement the national strategy to accelerate the reduction of stunting in Indonesia through a family-based intervention approach. Family-based intervention is proven scientifically efective in preventing growth retardation in children under five. However, this research was conducted on families with children aged 0-2 years so that all of the presented problems can be used as a reference in providing family-based interventions. This study aims to describe family health practices in preventing stunting among the people in the border areas of Indonesia and Timor Leste. Subjects and Method: This was a quantitative descriptive study with a cross-sectional design, conducted from May to June 2022. A total of 257 families (out of a total population of 566) with children aged 0-24 months spread across 16 integrated healthcare centers (Posyandu) at the Haliwen Health Center, Belu District, East Nusa Tenggara Province, Indonesia. The subjects in this study were selected by simple random sampling. The single variable in this study was family health practices in preventing stunting, consists of 18 indicators adopted and elaborated from presidential regulation 72 concerning accelerating the reduction of stunting. the data collected by a set of questionnaires. The data analyze by univariate analysis to describe frequency (n) and percentage (%) of each indicators. Results: Out of a total of 18 assessed indicators, most families still use open garbage cans, burning garbage for destruction, and did not carry out pre-marital health screening. Conclusion: The results of this study showed that most of the health indicators had been carried out by families with infants under two years old. It is in line with the growth status of under-two, most of whom are not stunted. Keywords: stunting, children under two, family-based intervention. Correspondence: Maria Paula Marla Nahak. Nursing study program, Universitas Timor, Indonesia. Jln. El Tari - Km. 09, Sasi, Kefamenanu, Timor Tengah Utara, Nusa Tenggara Timur, Indonesia. Email: paulamarla@­unimor.ac.id.

Changes of GH-IGFs and its relationship with growth retardation in children with bronchial asthma

ObjectiveTo explore the relationship between Growth Hormone Insulin-like Growth Factors (GH-IGFs) and growth retardation in children with bronchial asthma. Methods112 children with bronchial asthma and 50 healthy children were studied. Serum GH, IGF-1, and Insulin-like Growth Factor Binding Protein 3 (IGFBP3) were assessed by ELISA. GH-IGFs-related parameters were compared, and the correlation between the parameters and bronchial asthma severity was analyzed. The bronchial asthma group was divided into the growth retardation group and non-growth retardation group to analyze the diagnostic value of GH-IGFs in growth retardation and the relationship between GH-IGFs and growth retardation. ResultsGH, IGF-1, and IGFBP3 in the bronchial asthma group were lower. GH, IGF-1, and IGFBP3 levels were decreased with the severity of bronchial asthma. GH, IGF-1, and IGFBP3 in the growth retardation group were lower than those in the non-growth retardation group. The AUC of GH-IGFs combined detection was higher than that of GH and IGFBP3 alone detection. GH < 9.27 μg/L and IGF-1 < 179.53 mmoL/L were risk factors for growth retardation in patients with bronchial asthma. ConclusionGH-IGFs-related parameters have diagnostic value for growth retardation in children, and decreased levels of GH and IGF-1 are risk factors for growth retardation in children.

Kindergarten dust heavy metal(loid) exposure associates with growth retardation in children.

Heavy metal contamination from electronic waste recycling sites is present in dust found in indoor kindergartens located in e-waste recycling areas, and its potential impact on child health is a significant concern. The association between heavy metal(loid)s and the child developmental indicators is still unclear. In 2019 and 2020, we enrolled 325 and 319 children in an e-waste recycling town, respectively. Corresponding 61 and 121 dust samples were collected from roads, houses, and kindergartens in the two years. The median concentrations of metals, including Cr, Ni, Cu, Zn, and Pb exceeded the allowable limits. The highest amount of cumulative enrichment (cEF) was observed in indoor kindergarten dust (cEF = 112.3400), followed by house dust (cEF = 76.6950) and road dust (cEF = 39.7700). Children residing in the e-waste town had below-average height and weight compared to their Chinese peers. Based on linear regression analysis, the daily intake of Cd, V, Mn, and Pb in indoor kindergarten dust was found to be negatively associated with head circumference (HeC) (P < 0.05). Similarly, the daily intake of As, Cd, and Ba in indoor kindergarten dust was found to be negatively associated with chest circumference (ChC) (P < 0.05). In addition, the daily intake of As, Cd, and Ba in indoor kindergarten dust was negatively correlated with body mass index (BMI), as per the results of the study (P < 0.05). Cross-product term analysis revealed a negative correlation between daily intake of heavy metal(loid)s and HeC, ChC, and BMI, with age and sex serving as influencing factors. In conclusion, exposure to heavy metal(loid)s in indoor kindergarten dust increases the risk of growth retardation and developmental delay in children.

Role of epigenetic modifications and aging in inflammatory bowel disease

AbstractInflammatory bowel disease (IBD), which encompasses ulcerative colitis (UC) and Crohn's disease (CD), refers to a chronic and recurrent nonspecific inflammatory condition affecting the mucosal and submucosal layers of the intestines. A positive family history has been identified as a risk factor for the onset of IBD, likely influenced by genetic and environmental factors. In addition to intestinal damage, patients may have extraintestinal manifestations such as inflammation of the skin, eyes, and joints, inflammation of the liver or bile ducts, kidney stones, iron‐deficiency anemia, and growth retardation in children, which may complicate diagnosis and treatment. Therefore, investigating the mechanisms of IBD and finding precise therapeutic targets provides enormous benefits to patients with IBD. Multiple studies have consistently demonstrated the influential role of dietary metabolism and aging in the development of IBD. Moreover, emerging evidence suggests that aging often coincides with alterations in epigenetic modifications, while diet metabolism mediates these epigenetic changes. Epigenetics has emerged as a prospective field for identifying novel biomarkers to facilitate the diagnosis, prognosis, and treatment of diseases. Therefore, in this perspective, we summarize the cross‐talk between epigenetic modifications, diet metabolism, and aging in the pathogenesis of IBD and attempt to identify new potential therapeutic targets and strategies.

CRISPR/Cas-based gene editing in therapeutic strategies for beta-thalassemia.

Beta-thalassemia (β-thalassemia) is an autosomal recessive disorder caused by point mutations, insertions, and deletions in the HBB gene cluster, resulting in the underproduction of β-globin chains. The most severe type may demonstrate complications including massive hepatosplenomegaly, bone deformities, and severe growth retardation in children. Treatments for β-thalassemia include blood transfusion, splenectomy, and allogeneic hematopoietic stem cell transplantation (HSCT). However, long-term blood transfusions require regular iron removal therapy. For allogeneic HSCT, human lymphocyte antigen (HLA)-matched donors are rarely available, and acute graft-versus-host disease (GVHD) may occur after the transplantation. Thus, these conventional treatments are facing significant challenges. In recent years, with the advent and advancement of CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9 (CRISPR-associated protein 9) gene editing technology, precise genome editing has achieved encouraging successes in basic and clinical studies for treating various genetic disorders, including β-thalassemia. Target gene-edited autogeneic HSCT helps patients avoid graft rejection and GVHD, making it a promising curative therapy for transfusion-dependent β-thalassemia (TDT).In this review, we introduce the development and mechanisms of CRISPR/Cas9. Recent advances on feasible strategies of CRISPR/Cas9 targeting three globin genes (HBB, HBG, and HBA) and targeting cell selections for β-thalassemia therapy are highlighted. Current CRISPR-based clinical trials in the treatment of β-thalassemia are summarized, which are focused on γ-globin reactivation and fetal hemoglobin reproduction in hematopoietic stem cells. Lastly, the applications of other promising CRISPR-based technologies, such as base editing and prime editing, in treating β-thalassemia and the limitations of the CRISPR/Cas system in therapeutic applications are discussed.

Early prediction of growth patterns after pediatric kidney transplantation based on height-related single-nucleotide polymorphisms.

Growth retardation is a common complication of chronic kidney disease in children, which can be partially relieved after renal transplantation. This study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease (ESRD) after kidney transplantation using machine learning algorithms based on genomic and clinical variables. A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing (WES), and another 39 children who underwent transplant from September 2021 to March 2022 were enrolled for external validation. Based on previous studies, we comprehensively collected 729 height-related single-nucleotide polymorphisms (SNPs) in exon regions. Seven machine learning algorithms and 10-fold cross-validation analysis were employed for model construction. The 110 children were divided into two groups according to change in height-for-age Z-score. After univariate analysis, age and 19 SNPs were incorporated into the model and validated. The random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve (AUC) of 0.924, and also performed well in the external validation cohort (accuracy, 0.7949; AUC, 0.796). A model with good performance for predicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning algorithms. The model is expected to guide clinicians in the management of children after renal transplantation, including the use of growth hormone, glucocorticoid withdrawal, and nutritional supplementation, to alleviate growth retardation in children with ESRD.

Nutritional Status and Metabolism in Celiac Disease: Narrative Review.

This review summarizes findings from studies assessing the nutritional status of patients with celiac disease (CD). Malnutrition, including over- and undernutrition, may be present in CD, both at diagnosis and while under treatment. Underweight and growth retardation in children, which mostly reflect malabsorption as a consequence of intestinal inflammation, are not a rule. Clinical presentations of CD can vary widely, and each manifestation has its own characteristics. Evaluating various nutritional parameters can be beneficial for CD patients and may improve health outcomes by facilitating an accurate definition of dietary needs and the development of a balanced diet that not only focuses on eliminating gluten but also provides adequate nutrients, alters metabolism, and reduces the risk of other disorders developing. The cornerstone of CD therapy is a gluten-free diet (GFD), which improves nutritional status, but even on a GFD, features of malnutrition may be present. Additionally, overweight and obesity may occur in patients on a GFD, with typical metabolic consequences.

Dampak Buruk Stunting Bagi Anak pada Usia Golden Age di Desa Pasiran Kecamatan Sei Dadap Kabupaten Asahan

Stunting is a condition where a child's height is shorter than a child of the same age, with a Z-score for height for age (TB/U). Based on the standard of growth reached less than -2 standard deviation (SD). Poor nutrition during the first 1000 days of life causes growth retardation in children. Affected children have permanent physical developmental disabilities that affect their ability to work. The average IQ of retarded children is 11 points lower than the average IQ of children in the general population. The research method used in this research is a systematic review of published literature from national and international publications. The object of this research is in Pasiran Village, Sei Dadap District, Asahan Regency. The results of this study reveal that children who experience stunting in the first 2 years of life are at risk of having an IQ of 4.57 and a nonverbal IQ of less than 89.

Population health and sociodemographic variables as predictors of access to cardiac medicine and surgery in Haiti

BackgroundIn Haiti, cardiovascular disease is a leading cause of morbidity and mortality, with congenital and rheumatic heart disease comprising a large portion of disease burden. However, domestic disparities in cardiac care access and their impact on clinical outcomes remain poorly understood. We analyzed population-level sociodemographic variables to predict cardiac care outcomes across the 10 Haitian administrative departments.MethodsThis cross-sectional study combined data from a 2016–17 Haitian national survey with aggregate outcomes from the Haiti Cardiac Alliance (HCA) database (n = 1817 patients). Using univariate and multivariable regression analyses, the proportion of HCA patients belonging to each of three clinical categories (active treatment, lost to follow-up, deceased preoperatively) was modeled in relation to six population-level variables selected from national survey data at the level of the administrative department.ResultsIn univariate analysis, higher department rates of childhood growth retardation were associated with a lower proportion of patients in active care (OR = 0.979 [0.969, 0.989], p = 0.002) and a higher proportion of patients lost to follow-up (OR = 1.016 [1.006, 1.026], p = 0.009). In multivariable analysis, the proportion of department patients in active care was inversely associated with qualified prenatal care (OR = 0.980 [0.971, 0.989], p = 0.005), and child growth retardation (OR = 0.977 [0.972, 0.983]), p = 0.00019). Similar multivariable results were obtained for department rates of loss to follow-up (child growth retardation: OR = 1.018 [1.011, 1.025], p = 0.002; time to nearest healthcare facility in an emergency: OR = 1.004 [1.000, 1.008, p = 0.065) and for preoperative mortality (prenatal care: OR = 0.989 [0.981, 0.997], p = 0.037; economic index: OR = 0.996 [0.995, 0.998], p = 0.007; time to nearest healthcare facility in an emergency: OR = 0.992 [0.988, 0.996], p = 0.0046).ConclusionsPopulation-level survey data on multiple variables predicted domestic disparities in HCA clinical outcomes by region. These findings may help to identify underserved areas in Haiti, where increased cardiac care resources are required to improve health equity. This approach to analyzing clinical outcomes through the lens of population-level survey data may inform future health policies and interventions designed to increase cardiac care access in Haiti and other low-income countries.

Prevalence of Failure to Thrive and Associated Risk Factors in In-patients Under 5 Years of Age

Background: Failure to thrive (FTT) is defined as delaying or stopping a child’s growth and mightlead to more serious complications, such as reduced learning ability, mental or physical disability, and mortality. Objectives: The present study aimed to assess the prevalence of growth retardation in children under 5 years of age and its risk factors. Methods: This cross-sectional study was conducted on all 2038 children admitted to Ali Ebne Abitalib and Ali Asghar hospitals in Zahedan, Iran, in 2016. The samples entered the study based on census sampling, and the children’s height, weight, and other growth indices were measured. The children with confirmed growth retardation were recognized as the case group. Other children were regarded as controls. The parents’ characteristics were recorded in a list provided for this purpose. Data analysis was performed with SPSS software (version 20) using logistic regression with an error level of 0.05. Results: Of all children, 52.6% were male. The mean age of the total patients was 17.6 ± 4.14 months. The prevalence of children with growth failure was 747 patients (36.6%). In this study, the prevalence of short stature was significantly associated with factors such as parental height, low household level of education, high patients’ birth order, dry feeding, low birth weight, place of residence, and presence of background disease (P &lt; 0.05). Nevertheless, the prevalence of short stature was not significantly associated with gender, age, polygamy status, age of complementary feeding, and gestational age (P &gt; 0.05). Conclusions: The present study concluded that the prevalence of FTT was high due to socioeconomic factors in the studied society. Parental short stature, education, nutrition, low birth weight, and residence in rural areas were the most significant factors.

Retracted: Vitamin AD Drops are More Effective than Intramuscular Injection of Thymosin in Reducing the Rate of Growth Retardation in Children.

[This retracts the article DOI: 10.1155/2022/7799111.].

Growth retardation in children with allergies: A review

The increase in the prevalence of food allergies among children in recent years is evident with onset in infancy and childhood in most cases. The full value of the elimination diet, the time before diagnosis, and the severity of allergic inflammation can affect the nutritional status of the children and, ultimately, their linear growth. Age-correspondent height is one of the most important indicators of a child's health and well-being, especially in the first few years of life when energy and nutrient requirements per body weight are highest. Insufficient nutrient intake in children with food allergies can impair growth, and developmental delay in infancy and early childhood can have long-term sequelae. It is essential to understand the frequency of developmental retardation in kids with food allergies, the most prevalent allergen that causes it, and whether or not growth retardation may be reversed with effective diet therapy. Based on the studies presented in the article, the following key provisions were identified: of the entire spectrum of food allergens, cow milk protein allergy (CMPA) has the most significant effect on growth; the impact of CMPA on the formation of improper eating habits is also high; careful management of a child with CMPA with adequate diet therapy and timely re-introduced dairy products to induce tolerance can reduce the adverse effect of CMPA on growth and nutrition; apparently, multiple food allergies also harm growth; a nutritionist should more often observe children with multiple food allergies; regular assessment of growth and diet with individual nutrition recommendations to date has shown the best results in achieving the growth target of children with food allergies.

Nutrient-regulated dynamics of chondroprogenitors in the postnatal murine growth plate

Longitudinal bone growth relies on endochondral ossification in the cartilaginous growth plate, where chondrocytes accumulate and synthesize the matrix scaffold that is replaced by bone. The chondroprogenitors in the resting zone maintain the continuous turnover of chondrocytes in the growth plate. Malnutrition is a leading cause of growth retardation in children; however, after recovery from nutrient deprivation, bone growth is accelerated beyond the normal rate, a phenomenon termed catch-up growth. Although nutritional status is a known regulator of long bone growth, it is largely unknown whether and how chondroprogenitor cells respond to deviations in nutrient availability. Here, using fate-mapping analysis in Axin2CreERT2 mice, we showed that dietary restriction increased the number of Axin2+ chondroprogenitors in the resting zone and simultaneously inhibited their differentiation. Once nutrient deficiency was resolved, the accumulated chondroprogenitor cells immediately restarted differentiation and formed chondrocyte columns, contributing to accelerated growth. Furthermore, we showed that nutrient deprivation reduced the level of phosphorylated Akt in the resting zone and that exogenous IGF-1 restored the phosphorylated Akt level and stimulated differentiation of the pooled chondroprogenitors, decreasing their numbers. Our study of Axin2CreERT2 revealed that nutrient availability regulates the balance between accumulation and differentiation of chondroprogenitors in the growth plate and further demonstrated that IGF-1 partially mediates this regulation by promoting the committed differentiation of chondroprogenitor cells.

Impact of eating behavior on growth retardation in children

Impact of eating behavior on growth retardation in children

TNF overexpression and dexamethasone treatment impair chondrogenesis and bone growth in an additive manner

Children with chronic inflammation are often treated with glucocorticoids (GCs) and many of them experience growth retardation. It is poorly understood how GCs interact with inflammatory cytokines causing growth failure as earlier experimental studies have been performed in healthy animals. To address this gap of knowledge, we used a transgenic mouse model where human TNF is overexpressed (huTNFTg) leading to chronic polyarthritis starting from the first week of age. Our results showed that femur bone length and growth plate height were significantly decreased in huTNFTg mice compared to wild type animals. In the growth plates of huTNFTg mice, increased apoptosis, suppressed Indian hedgehog, decreased hypertrophy, and disorganized chondrocyte columns were observed. Interestingly, the GC dexamethasone further impaired bone growth, accelerated chondrocyte apoptosis and reduced the number of chondrocyte columns in huTNFTg mice. We conclude that TNF and dexamethasone separately suppress chondrogenesis and bone growth when studied in an animal model of chronic inflammation. Our data give a possible mechanistic explanation to the commonly observed growth retardation in children with chronic inflammatory diseases treated with GCs.

SIRT1 targeted by miR-211-5p regulated proliferation and apoptosis of Dex-treated growth plate chondrocytes via mediating SOX2.

Dexamethasone (Dex) is reported to cause bone growth retardation in children, which is associated with the increased apoptosis and decreased proliferation of growth plate chondrocytes. Sirtuin 1 (SIRT1) plays an important role in chondrocyte function and homeostasis. Thus, we further explored the regulatory mechanism of SIRT1 in Dex-induced growth plate chondrocyte dysfunction. SIRT1 expression was detected in Dex-treated growth plate chondrocytes using RT-qPCR and western blot assay. The modulation of SIRT1 on SOX2 expression was evaluated. Besides, we identified that SIRT1 was targeted by miR-211-5p using TargetScan and RNA pull-down assay. A loss-of-function assay was performed to evaluate the effects of miR-211-5p on Dex-induced growth plate chondrocyte dysfunction in vitro and in vivo. We found that SIRT1 was downregulated in Dex-treated growth plate chondrocytes. The expression of SOX2 was upregulated by overexpression SIRT1. Meanwhile, downregulation of SOX2 weakened the positive function of SIRT1 overexpression on Dex-induced growth plate chondrocytes dysfunction. Subsequently, we confirmed that SIRT1 was targeted by miR-211-5p. MiR-211-5p inhibitor increased the expression levels of SIRT1 and SOX2, and restored the Dex-treated growth plate chondrocyte function. Animal assays further demonstrated that the effects of miR-211-5p on the growth plate chondrogenesis. In conclusion, our data suggest that SIRT1 exerts a protective effect on growth plate chondrocyte under Dex stimulation. MiR-211-5p/SIRT1/SOX2 axis regulates the process of Dex-inhibited growth plate chondrogenesis.

Effects of Proton Craniospinal Radiation on Vertebral Body Growth Retardation in Children

It is of great interest to physicians and patients/patients' families to be able to predict the amount of growth decrement after craniospinal irradiation (CSI). Little data exist on the effect of proton CSI. Our aim was to determine the effect of proton CSI on vertebral body (VB) growth retardation, and to identify factors associated with growth delay. We performed a retrospective outcome data analysis of 80 patients <16 years old with central nervous system tumors who received proton radiation therapy (PRT) at the Massachusetts General Hospital between 2002 and 2010 with available spinal magnetic resonance imaging. Forty-eight patients received CSI, and 32 patients with brain tumors who received focal cranial irradiation served as controls. VB height was measured midline using sagittal T1-weighted contrast or noncontrast enhanced magnetic resonance imaging of the spine. Measurements were repeated at multiple levels (C3, C3-C4, T4, T4-T5, C3-T6, T4-T7, L3, L1-L5) on available scans for the duration of follow-up. Data were fitted using a mixed-effects multivariable regression model, including follow-up time, CSI dose, age at CSI, and pretreatment VB percentile as parameters. Median follow-up was 69.6 months for patients treated with proton CSI and 52.9 months for the control group. There was a significant association of CSI dose, follow-up time, age at treatment, and pretreatment VB percentile with VB growth retardation. Growth retardation was shown to be independent of gender or growth hormone deficiency. Although the current practice of PRT CSI delivery allows for sparing of the organs anterior to the spine, the vertebral column receives radiation therapy because of its close proximity to the targeted spinal canal. In growing children, the whole VB has generally been included so that growth impairment is even across the VB. We present a quantitative model predicting the growth retardation of patients treated with PRT CSI based on age at treatment, CSI dose, follow-up time, and pretreatment growth percentile.