Growth patterns and associated factors among children receiving long-term inhaled corticosteroid therapy for asthma. A hospital-based prospective observational cohort study.
DOI:
https://doi.org/10.51168/0w3aww20Keywords:
asthma, children, growth velocity, height-for-age z score, inhaled corticosteroids, linear growthAbstract
Background
Inhaled corticosteroids (ICS) are central to persistent asthma management in children, but prolonged exposure may affect linear growth, particularly at higher doses or with repeated systemic corticosteroid use.
Objectives
To describe growth patterns and identify factors associated with reduced height velocity among children receiving long-term ICS therapy for asthma.
Methods
This prospective observational cohort study included 100 children aged 5–14 years at RSDKS Government Medical College, Ambikapur, Chhattisgarh, India. Demographic characteristics, asthma severity and control, corticosteroid exposure, adherence, and anthropometric measurements were recorded. Height, weight, and corresponding z scores were assessed at baseline, 6 months, and 12 months. Reduced height velocity was defined as below the age- and sex-specific 25th percentile. Associated factors were evaluated using logistic regression.
Results
The mean age was 9.2 ± 2.6 years, and 61.0% were boys. Mean annual height velocity was 5.3 ± 1.1 cm/year, and the mean height-for-age z score declined from −0.39 ± 0.86 at baseline to −0.48 ± 0.89 at 12 months (p<0.001). Reduced height velocity occurred in 19/100 (19.0%) children. Annual height velocity was 5.8 ± 0.9, 5.2 ± 0.9, and 4.3 ± 1.0 cm/year in the low-, medium-, and high-dose groups, respectively (p<0.001); the corresponding proportions with reduced height velocity were 7.5%, 19.0%, and 44.4% (p=0.004). In multivariable analysis, high-dose inhaled corticosteroid therapy (adjusted odds ratio 4.21, 95% confidence interval 1.28–13.86; p=0.018), two or more systemic corticosteroid courses (adjusted odds ratio 3.47, 95% confidence interval 1.05–11.50; p=0.042), and baseline height-for-age z score below −1 (adjusted odds ratio 3.22, 95% confidence interval 1.02–10.19; p=0.047) remained independently associated with reduced growth.
Conclusion
Most children maintained acceptable growth, although a clinically relevant subgroup demonstrated reduced linear growth..
Recommendations
Serial height monitoring, optimal asthma control, and use of the lowest effective ICS dose are recommended, particularly in higher-risk children.
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Copyright (c) 2026 Dr . Ankit Kumar Gupta, Dr. Alok Singh, Dr. Shivani Thakur (Author)
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