The effect of early childhood stature on later cognitive functions in Indonesian adolescents: comparation using the National growth reference and the WHO growth standard

Background: The prevalence of short stature in children under 5 using the National Growth Reference vs. the WHO Growth Standard is known to vary in many countries. Previous research has suggested possible associations between short stature early in childhood, frequently regarded as stunting, and later cognitive function. Objective: This study aimed to identify the effect of early childhood stature, using the National Indonesian Growth Chart (NIGC) vs. the WHO Growth Standard (WHO), on cognitive function in adolescence. Methods: The study used two cohort data from the Indonesia Family Life Surveys (IFLS) that had both anthropometric data at the age of 2-5 years and at adolescence, as well as information on cognitive function at adolescence. At the age of 2-5 years, the height-for-age Z-score (HAZ) of the subjects were classified using both NIGC and WHO as follows: Normal NIGC & Normal WHO; Normal NIGC & Short WHO; and Short NIGC & Short WHO. In adolescence, cognitive function were assessed. An analysis was performed to assess the associations between variables. Results: Cohort-1 included 866 subjects with complete information, while Cohort-2 included 1,436 subjects. After adjustment, subjects aged 2 to 5 years classified as Short NIGC & Short WHO had a consistent significantly negative effect on their later adolescent cognitive function: coefficient regression (95CI): -2.82 (-5.58)-(-0.06), p = 0.046for Cohort-1 and 4.13 (-7.22)-(-1.04), p = 0.009 for Cohort-2. On the other hand, those classified as Short for WHO but Normal for NIGC were not associated with later negative cognitive function: coefficient regression (95CI): -1.88 (-4.00)- 0.24, p = 0.082 for Cohort-1 and 1.32 (-3.50)-0.87, p = 0.237 for Cohort-2. Cognitive function of both cohorts was also significantly influenced by the subjects education, parental education and resicence in urban and Java-Bali (p < 0.05). Conclusions: Childhood stature was associated with later negative cognitive function only when the children were classified as short using NIGC. Classified as short stature using WHO, but not short using NIGC, was not associated with later negative cognitive function. Clinical trial number: Not applicable. © The Author(s) 2025.