Early growth in children with coeliac disease: a cohort study

Area of Science:

• Pediatric Gastroenterology
• Growth and Development Studies
• Epidemiology of Autoimmune Diseases

Background:

• Understanding early growth patterns in children who later develop celiac disease is crucial, especially with evolving diagnostic methods and changing disease epidemiology.
• Previous research has not consistently identified specific growth trajectories preceding a celiac disease diagnosis in early childhood.

Purpose of the Study:

• To compare the growth (height and weight) during the first two years of life in children subsequently diagnosed with celiac disease versus those without the condition.
• To investigate the onset and progression of growth differences in relation to the timing of celiac disease diagnosis.

Main Methods:

• Prospective, population-based cohort study involving 58,675 children from the Norwegian Mother and Child Cohort Study (2000-2009).
• Growth data (height, weight z-scores) were collected prospectively from birth to 24 months.
• Celiac disease diagnosis was confirmed using questionnaires and the Norwegian Patient Register; statistical analyses included linear regression and mixed models.

Main Results:

• Children diagnosed with celiac disease exhibited significantly lower height z-scores from 12 months and weight z-scores from 15-18 months compared to controls.
• Longitudinal analysis revealed a significant annual reduction in height z-score (0-24 months) in children with celiac disease.
• These growth differences were observed even when excluding children diagnosed before age two, suggesting early developmental impact.

Conclusions:

• Growth retardation in children who are later diagnosed with celiac disease commonly begins around 12 months of age.
• The observed growth faltering precedes the typical clinical symptoms that prompt celiac disease diagnosis.
• Findings underscore the importance of monitoring growth in early childhood for potential indicators of undiagnosed celiac disease.