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Growth and development in paediatric onset inflammatory bowel disease: Data analysis from the CEDATA registry
Ilse Broekaert1, Anna Schmidt1, Christoph Hünseler1
1Department of Paediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Insights
Pediatric inflammatory bowel disease (IBD) therapies impact growth. Enteral nutrition (EEN) and disease control significantly improve weight and BMI in children with IBD, but height catch-up is limited.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Childhood Growth and Development
Background:
- Inflammatory bowel disease (IBD) affects children and adolescents, necessitating tailored therapeutic approaches.
- Growth and development are critical parameters in pediatric IBD management.
- Understanding therapy effects on growth is crucial for optimizing treatment algorithms.
Purpose of the Study:
- To analyze the impact of different therapies on the growth and development of pediatric patients with Crohn's disease (CD) and ulcerative colitis (UC).
- To identify factors influencing growth trajectories in children and adolescents with IBD.
- To support the development of specific therapy algorithms for pediatric IBD.
Main Methods:
- Analysis of growth and development data from the German-Austrian CEDATA-GPGE registry (2004-2021).
- Inclusion of pediatric patients (0-18 years) with complete follow-up data on diagnoses and therapies.
- Multivariate analysis comparing standard deviation scores (SDS) for height, weight, and BMI at initial diagnosis (t0) and 4-year follow-up (t4).
Main Results:
- Initial SDS values for height, weight, and BMI were below average in 450 analyzed pediatric IBD patients (CD: 303; UC: 147).
- Significant improvements in SDS for weight and BMI were observed between t0 and t4, with small effect sizes.
- Exclusive enteral nutrition (EEN) and azathioprine improved weight and BMI, while corticosteroids led to weight gain; height SDS did not significantly improve.
Conclusions:
- Enteral nutrition (EEN) and effective disease control significantly enhance weight and body mass index (BMI) in pediatric IBD patients.
- Height catch-up growth was primarily observed in subgroups with pre-existing growth impairment.
- Children experiencing severe flares or persistent nutritional deficits require vigilant medical monitoring due to elevated risks of impaired growth.
Objective:
Different therapies may affect the growth and development of children and adolescents with inflammatory bowel disease (IBD) supporting specific therapy algorithms for paediatric Crohn's disease (CD) and ulcerative colitis (UC).
Methods:
Growth and development data from the German-Austrian CEDATA-GPGE registry entered between 2004 and 2021 were analysed for 0-18 year olds with complete follow-up on diagnoses and therapies. Standard deviation scores (SDS) for height, weight, and body mass index (BMI) were compared between initial diagnosis (t0) and 4-year follow-up (t4) within groups using multivariate analysis. Factors included gender, age, disease type, age at diagnosis, and initial therapies.
Results:
Data from 450 patients (CD: 303; UC: 147) were analysed. At t0, SDS values for height (mean value [M] = -0.37, standard deviation [SD] = 1.07), weight (M = -0.57, SD = 0.92), and BMI (M = -0.55, SD = 0.95) were below average. The SDS values for weight and BMI increased significantly between t0 and t4 with small effect sizes, whereas the SDS value for height did not. Diagnosis, gender, disease localisation, and remission after 6 months did not influence height SDS. Patients treated exclusively with enteral nutrition (EEN) or azathioprine showed improved weight and BMI development, whereas corticosteroids led to weight gain.
Conclusion:
The analysis showed that EEN and disease control significantly improve weight and BMI in children with IBD, SDS-H catch-up was only observed in the subgroup with growth impairment at initial diagnosis. Children with severe or recurrent flares, or persistent nutritional deficits, are at increased risk of growth impairment and require close medical monitoring.
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