Growth Outcomes in Children Receiving Long-Term Inhaled Corticosteroids: A Hospital-Based Retrospective Cohort Study.
DOI:
https://doi.org/10.51168/epfmbr11Keywords:
bronchial asthma, children; growth velocity, height-for-age Z-score, inhaled corticosteroids, linear growthAbstract
Background:
Inhaled corticosteroids are widely used for long-term control of bronchial asthma in children. Although they improve airway inflammation and reduce exacerbations, their prolonged use has raised concern regarding possible effects on linear growth.
Objectives:
To assess growth outcomes among children receiving long-term inhaled corticosteroid therapy and to evaluate the association of growth parameters with dose category and duration of treatment.
Methods:
A hospital-based retrospective cohort study was conducted at Konaseema Institute of Medical Sciences, Amalapuram, from September 2025 to February 2026. Consecutive records of children aged 5-14 years with bronchial asthma, at least one year of regular inhaled corticosteroid use, and serial anthropometric measurements were screened. Of 112 records assessed, 100 eligible records were analyzed. Inhaled corticosteroid exposure and growth indices, including annual height velocity and Z-score changes, were evaluated.
Results:
The mean age was 8.4 +/- 2.6 years, and 58.0% were males. The mean duration of inhaled corticosteroid use was 2.8 +/- 1.3 years. The mean height-for-age Z-score declined from -0.62 +/- 0.88 at baseline to -0.81 +/- 0.92 at follow-up, with a mean change of -0.19 +/- 0.34. The mean annual height velocity was 5.1 +/- 1.2 cm/year. High-dose therapy was associated with lower height velocity and greater decline in height-for-age Z-score. Suboptimal growth was observed in 21.0% of children.
Conclusion:
Long-term inhaled corticosteroid therapy was associated with mild reduction in linear growth, particularly among children receiving high-dose therapy and those with longer treatment duration. Weight-related growth indices showed minimal change.
Recommendations:
Regular anthropometric monitoring, use of the lowest effective inhaled corticosteroid dose, and periodic reassessment of asthma control are recommended during long-term pediatric asthma management.
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Copyright (c) 2026 Dr. Veera Sowjanya Bhanu, Dr. Lakshmi Ramya Gontla, Dr. Kondru V D Sai Sujana (Author)
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