Prevalence and Predictors of Growth Impairment and Short Stature in Pediatric-Onset Inflammatory Bowel Disease

Abstract

<b><i>Background and Aims:</i></b> Growth impairment is common in children with inflammatory bowel diseases (IBD). However, the magnitude of short stature at adulthood is not well characterized. We aimed to determine the prevalence and predictors of growth impairment at diagnosis and adulthood in children with IBD. <b><i>Methods:</i></b> Height z-scores at diagnosis of IBD and at adulthood among 291 children with Crohn’s disease (CD) and 125 with ulcerative colitis (UC) were retrieved retrospectively and compared to matched controls. Growth impairment at diagnosis was defined as height z-score for age less than or equal to –1 and short stature at adulthood as less than or equal to –2. <b><i>Results:</i></b> Mean height z-score at adulthood in subjects with CD or UC was significantly different from controls although mean height did differ in males only (CD 172.3 cm ± 6.7, UC 172.7 cm ± 5.3, controls: 174.2 cm ± 7.3, <i>p</i> = 0.003 and <i>p</i> = 0.047, respectively). Diagnosis prior to final stage of puberty and male gender were risk factors for being short statured at adulthood in CD (mean difference [MD] 2.5, <i>p</i> = 0.013 and MD 6.25, <i>p</i> = 0.001, respectively) and UC (MD 4.9, <i>p</i> = 0.011 and MD 3.3, <i>p</i> = 0.034, respectively). <b><i>Conclusion:</i></b> Increased proportion of pediatric-onset IBD patients has growth impairment at adulthood. Male gender and diagnosis prior to puberty were found to impose risk for reduced adult height in both diseases.