Nutritional and Lifestyle Factors Associated with Rickets in Children Under Three Years of Age at a Tertiary Care Hospital in Abbottabad
DOI:
https://doi.org/10.52206/jsmc.2026.16.1.1124Abstract
Background: Rickets is a pediatric bone disorder characterized by defective mineralization of growing bone and cartilage. Despite being largely preventable, nutritional rickets remains a significant public health concern, particularly in low- and middle-income countries. Changing lifestyles, poor maternal nutrition, inadequate sunlight exposure, and suboptimal infant feeding practices have contributed to its re-emergence globally.
Objective: To assess the association of modifiable nutritional and lifestyle factors with the prevalence of nutritional rickets in children under three years of age presenting to a tertiary care hospital.
Methodology: This cross-sectional observational study was conducted at Ayub Medical Complex, Abbottabad, from 4 October 2024 to 5 July 2025. A total of 150 children under three years of age with clinical or radiological suspicion of nutritional rickets were enrolled using a non-probability purposive sampling technique. Diagnosis was supported through clinical examination, biochemical investigations, and measurement of serum 25-hydroxyvitamin D levels using ELISA. Data regarding feeding practices, sunlight exposure, maternal education, and supplementation were collected through structured parental interviews. Statistical analysis was performed using SPSS version 28, with age- and gender-based stratification.
Results: Among the 150 children, 60% were boys and 40% were girls, with nearly half of the cases occurring in infants ≤10 months of age. Vitamin D deficiency was identified in 81.6% of children and was particularly prevalent among those with low maternal education (75.5%). Inadequate sunlight exposure (35.4%), poor weaning practices (49.7%), animal milk feeding (48.3%), and undernutrition (46.9%) were frequently observed. Significant associations were found between these risk factors and both age and gender (p ≤ 0.05).
Conclusion: Nutritional rickets in young children is strongly associated with preventable nutritional and lifestyle factors, particularly lack of vitamin D supplementation, poor maternal awareness, inadequate weaning, and insufficient sunlight exposure. Early preventive strategies focusing on maternal education and infant nutrition are essential to reduce disease burden.
Keywords: Cervical Ripening, Foley Balloon Catheter, Labour Induction.
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