Impact of idiopathic short stature on children’s well-being: a nationwide study of short Danish children

Context: It remains unclear whether idiopathic short stature (ISS), defined as a height below -2.0 SD score (SDS) without an identifiable cause, adversely affects psychosocial well-being. Objective: To assess the psychosocial impact of ISS in children using nationwide registry and survey data. Design: The nationwide cohort study included children identified between 2012 and 2020 with follow-up questionnaire data up until 2022. Setting: School-aged children in Denmark. Patients or Other Participants: The National Child Health Register contained heights on 507 754 children of which 42 185 had heights below -2.0 SDS. Children with a diagnostic code associated with potential underlying causes for short stature in the Danish National Patient Registry were excluded. The final cohort included 16 121 children with ISS. Each child was matched to 5 controls by age, sex, and region. Interventions: None. Main Outcome Measures: Psychosocial well-being (bullying, loneliness, and insecurity) assessed by mandatory National Well-being Surveys (2015-2022). Odds ratios (ORs) were calculated across school grade levels. Results: Children with ISS had higher odds of feeling bullied (school grade levels 0-3: OR 1.03 [95% confidence interval (CI) 0.95-1.12]; 4-6: OR 1.37 [95% CI 1.24-1.56]; 7-9: OR 1.19 [95% CI 1.02-1.40]), lonely (0-3: OR 1.02 [95% CI 0.93-1.12]; 4-6: OR 1.15 [95% CI 1.06-1.27]; 7-9: OR 1.11 [95% CI 1.01-1.25]), and insecure (0-3: OR 1.08 [95% CI 1.00-1.17]; 4-6: OR 1.07 [95% CI 1.02-1.15]; 7-9: OR 1.09 [95% CI 1.04-1.19]). Conclusion: Children with ISS displayed increased psychosocial distress. These findings support psychosocial assessment in children with ISS to enable timely intervention.