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Children with chronic perennial asthma may experience delayed puberty, not growth retardation. Their growth eventually normalizes, reaching predicted adult height after puberty onset.
Area of Science:
- Pediatric Endocrinology
- Pulmonology
- Growth and Development
Background:
- Chronic perennial asthma affects children's growth and development.
- Understanding asthma's impact on pubertal timing is crucial for pediatric care.
Purpose of the Study:
- To investigate the long-term effects of chronic perennial asthma on children's growth and pubertal development.
- To determine if asthma or its treatment influences growth velocity and final adult height.
Main Methods:
- Prospective longitudinal study of 66 children with chronic perennial asthma over a mean of 13.1 years.
- Regular measurements of height and weight every six months.
- Assessment of pubertal development, including onset and progression.
Main Results:
- No evidence of growth retardation at study entry; growth followed normal patterns until approximately age 10.
- A significant tendency for delayed puberty onset was observed in both boys and girls, independent of asthma severity.
- Complete catch-up growth occurred after puberty onset, leading to attainment of predicted adult height.
- Inhaled beclomethasone dipropionate did not affect growth in children treated before and during puberty.
Conclusions:
- Asthma is associated with a delay in the onset of puberty, not direct growth retardation.
- The pre-adolescent deceleration in growth velocity in asthmatic children can mimic growth retardation.
- Asthma management, including inhaled corticosteroids, does not appear to impede overall growth or final height attainment.
Abstract:
Height and weight were measured every six months in a long term prospective study of 66 children with chronic perennial asthma for a mean 13.1 years. There was no evidence of growth retardation on entry into the study. Growth developed along normal lines in all 66 children until about 10 years, and in 35 of these children growth continued along normal lines throughout the whole period of follow up. Thirty children showed the physiological decelerating growth velocity pattern seen in children with delay in the onset of puberty, and one child had an early menarche. The tendency for delay in the onset of puberty was significant for both boys and girls and was noted to be independent of severity of asthma. Once puberty finally began in these children, complete catch up growth resulted in the attainment of the predicted adult height. Long term prophylactic inhalation of beclomethasone dipropionate in 26 children in a dosage up to 600 mcg/day before puberty and 400 mcg/day during puberty was shown not to affect growth. It is concluded that asthma had no direct influence on growth in height but was associated with delay in the onset of puberty. The pre-adolescent physiological deceleration of growth velocity that occurs in these children gives the impression of growth retardation.