Growth and development in paediatric onset inflammatory bowel disease: Data analysis from the CEDATA registry

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).

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.

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.

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.