Cohen 1940,11 Cohen MB, Weller RR, Cohen S. Anthropometry in children. Progress in allergic children as shown by increments in height, weight and maturity. Am J Dis Child. 1940;60:1058-66. United States |
Clinic-based observational study (case series) |
Five cases (three boys and two girls), aged 6-13 years, with allergic disorders (eczema, hay fever, rhinitis, and asthma) |
The milder cases affected weight gain, but more severe cases could affect both height and weight increments, and finally maturity. Growth impairment was associated with the activity of allergic disorders and was not permanent. Patients could completely overcome growth impairment when allergic disorders were controlled. |
Cohen 1948,22 Cohen MB, Abram LE. Growth patterns of allergic children. J Allergy. 1948;19:165-71. United States |
Clinic-based observational study (retrospective analysis) |
150 (94 boys and 55 girls) children with asthma and other allergy, and 102 (51 boys and 51 girls) age-matched non-allergic controls |
From comparison of Wetzel Grid charts of growth between 150 allergic children and 102 non-allergic controls, it was observed that active allergy had deleterious effect on growth, and that control of allergy was associated with improved growth. |
Falliers 1961,33 Falliers CJ, Szentivanvi J, Mcbride M, Bukantz SC. Growth rate of children with intractable asthma. Observations on the influence of the illness and its therapy with steroids. J Allergy. 1961;32:420-34. United States |
Hospital-based observational study (prospective longitudinal) |
302 intractable asthmatic children (6-16 years) |
At enrollment, the heights of 83% of patients fell below the mean, or the 50th percentile for their respective sex and age and, in 20%, the heights were over 2 SD below the mean. |
Snyder 1967,88 Snyder RD, Collipp PJ, Greene JS. Growth and ultimate height of children with asthma. Clin Pediatrics. 1967;6:389-92. United States |
Hospital-based observational study (cross-sectional) |
150 children with allergic disorders (91 asthmatics and 59 other allergic diseases) and 69 non-allergic controls |
Mean heights in both controls and non-asthmatic allergic children were distributed much more closely around the 50th percentile than asthmatic children, and the latter tended to be short. The most severely affected asthmatics tended to be the smallest, with a mean height between the 10th and 25th percentile. The mean bone age, retarded by 9 months in the 21 males, was comparable to the mean height age. |
Hauspie 1977,99 Hauspie R, Susanne C, Alexander F. Maturational delay and temporal growth retardation in asthmatic boys. J Allergy Clin Immunol. 1977;59:200-6. Belgium |
Hospital-based observational study (mixed longitudinal) |
531 asthmatic boys (2-20 years) |
No growth retardation during infancy, a small but consistent retardation during childhood, a more pronounced delay during pubertal ages, and completely normal values beyond the age of 19 years. The mean adolescent growth spurt is delayed by about 1.3 years. Bone age assessment in a subsample of 370 patients showed a slight retardation between 6 and 13 years. |
Rona 1980,1010 Rona RJ, Florey CdV. National study of health and growth: respiratory symptoms and height in primary schoolchildren. Int J Epidemiol. 1980;9:35-43. UK |
School-based observational study (cross-sectional) |
7411 primary schoolchildren who had the height measures and parent-reported respiratory symptoms |
There was an inverse association between the height expressed in SD score and asthma severity in the last 12 months (absent, ≤ two episodes and ≥ three episodes), even after adjusting for parent's height, father's social class, and number of siblings (p < 0.001). |
Chang 1982,1111 Chang KC, Miklich DR, Barwise G, Chai H, Miles-Lawrence R. Linear growth of chronic asthmatic children: the effects of the disease and various forms of steroid therapy. Clin Allergy. 1982;12:369-78. United States |
Hospital-based observational study (retrospective analysis) |
231 children (6.2-16.2 years) with chronic severe asthma seen between 1964 and 1975) |
Patients who had never received oral steroids (n = 28), and those who received occasional oral steroids (n = 46), had comparable growth retardation, averaging approximately 1 SD below their age- and sex-specific predicted means. |
Nassif 1987,55 Nassif E, Weinberger M, Sherman B, Brown K. Extrapulmonary effects of maintenance corticosteroid therapy with alternate day prednisolone and inhaled beclomethasone in children with chronic asthma. J Allergy Clin lmmunol. 1987;80:518-28. United States |
Hospital-based observational study (retrospective analysis) |
56 asthmatic children requiring maintenance steroids and 41 controls (20 asthmatics not requiring maintenance steroids and 21 normal healthy children) |
The mean height of patients before starting maintenance steroids was at the 35th percentile. It was significantly lower than control subjects who, on average, were near the 50th percentile for both children with asthma not requiring maintenance steroids and normal healthy children. |
Shohat 1987,1212 Shohat M, Shohat T, Kedem R, Mimouni M, Danon YL. Childhood asthma and growth outcome. Arch Dis Child. 1987;62:63-5. Israel |
Retrospective analysis of military medical records |
92,143 adolescents (54,041 boys and 38,102 girls) were examined at the age of 17 years |
3410 adolescents (2252 boys and 1158 girls) had history of asthma, classified in grade A, B and C. Boys with mild and moderate asthma (grade A and B) were significantly taller than controls. The most severely affected children (grade C) were shorter than mild cases, but had similar height to the controls. The same tendency was found for girls, but the results were not significant. |
Oberger 1990,2828 Oberger E, Engström I, Karlberg J. Long-term treatment with glucocorticoids/ACTH in asthmatic children. III. Effects on growth and adult height. Acta Paediatr Scand. 1990;79:77-83. Sweden |
Hospital-based observational study (prospective longitudinal) |
40 children with severe asthma |
The mean height SD score was below the reference mean (p < 0.001) at start of treatment, and the mean height velocity SDS score (n = 30) was below the reference mean (p < 0.001) during the year immediately preceding the treatment. |
Ninan 1992,1313 Ninan TK, Russell G. Asthma, inhaled corticosteroid treatment, and growth. Arch Dis Child. 1992;67:703-5. United States |
Hospital-based observational study (prospective longitudinal) |
58 prepubertal children with chronic asthma |
Based on symptom score, asthma control was classified as good (≤5), moderate (6-10) and poor (>10). Before starting ICS treatment, height velocity SD score (mean, 95% CI) in children with good, moderate and poor asthma control was 0.01 (-0.27 to 0.30), -0.83 (-1.33 to -0.34) and -1.50 (-2.37 to -0.62), respectively. Height velocity SD score correlated negatively with control of asthma both before and after starting ICS (p < 0.001 for both). |
Agertoft 1994,1414 Agertoft L, Pedersen S. Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir Med. 1994;88:373-81. Denmark |
Randomized trial (baseline growth data only) |
278 children (3-11 years) with mild and moderate asthma (216 budesonide and 62 control) |
The height SD score (mean and range) at the run-in period was -0.09 (-3.2 to 3.5) in the budesonide group and -0.18 (-2.3 to 2.3) in the control group. |
Reid 1996,1515 Reid A, Murphy C, Steen HJ, McGovern V, Shields MD. Linear growth of very young asthmatic children treated with high-dose nebulized budesonide. Acta Paediatr. 1996;85:421-4. UK |
Hospital-based observational study (prospective longitudinal) |
40 infants and young children (<3 years old) with severe uncontrolled asthma |
The mean height SD score (SD) was -0.21 (1.1) at pre-treatment (at least 3 months before starting nebulized budesonide), and -0.46 (1.0) at the baseline (when budesonide was started). |
Saha 1997,1616 Saha MT, Laippala P, Lenko HL. Growth of asthmatic children is slower during than before treatment with inhaled glucocorticoids. Acta Paediatr. 1997;86:138-42. Finland |
Hospital-based observational study (retrospective analysis) |
201 prepubertal asthmatic children (43% mild, 29% moderate and 28% severe) |
Asthmatic children grew similarly to their healthy peers before starting ICS treatment: mean height SD score and mean height velocity SD score were +0.02 and +0.01 for boys, and -0.16 and +0.13 for girls, respectively. |
Kannisto 2000,1717 Kannisto S, Korppi M, Remes K, Voutilainen R. Adrenal suppression, evaluated by a low dose adrenocorticotropin test, and growth in asthmatic children treated with inhaled steroids. J Clin Endocrinol Metab. 2000;85:652-7. Finland |
Randomized trial (baseline growth data only) |
75 asthmatic children (5.5-14.7 years) (30 budesonide, 30 fluticasone and 15 cromone) |
The height SD score (mean ± SD) at study entry in the budesonide, fluticasone and cromone group was -0.07 ± 0.9, 0.31 ± 0.84 and -0.01 ± 1.11, respectively. |
Norjavaara 2000,1818 Norjavaara E, Gerhardsson De Verdier M, Lindmark B. Reduced height in Swedish men with asthma at the age of conscription for military service. J Pediatr. 2000;137:25-9. Sweden |
Retrospective analysis of military conscription records (1983, 1986, 1993, and 1996) |
173,034 18-year old conscripts (8531 asthmatics and 164,503 non-asthmatics) |
The mean height for asthmatics was lower than that for non-asthmatics (178.6 ± 6.6 cm vs. 179.3 ± 6.6 cm, p < 0.001). Asthma severity, classified as mild (no reduction in physical capacity), moderate (mild to moderate reduction in physical capacity), and severe (considerably reduction in physical capacity), had a negative correlation with height (p < 0.001). |
Kelly 2003,1919 Kelly HW, Strunk RC, Donithan M, Bloomberg GR, McWilliams BC, Szefler S, et al. Growth and bone density in children with mild-moderate asthma: a cross-sectional study in children entering the Childhood Asthma Management Program (CAMP). J Pediatr. 2003;142:286-91. United States |
Randomized trial (baseline growth data only) |
1041 children (5-12 year) with mild to moderate asthma |
The mean height percentile (SD) at baseline was 56.0 (28.5). Neither asthma severity (mild vs. moderate) nor its treatment in the 6 months before enrollment was associated with linear growth. |
Moudiou 2003,2020 Moudiou T, Theophilatou D, Priftis K, Papadimitriou A. Growth of asthmatic children before long-term treatment with inhaled corticosteroids. J Asthma. 2003;40:667-71. Greece |
Hospital-based observational study (cross-sectional) |
436 asthmatic children (3.9-15.4 years) not treated with long-term ICS and 710 age-matched healthy controls |
There was no significant difference in the height SD score between asthmatics and controls, except pubertal female patients that was significantly less than that of controls. There was no significant correlation between height SD score and asthma severity (51 intermittent, 172 mild persistent, 186 moderate persistent, and 27 severe persistent) or duration of the disease, allergy status, and other coexisting allergic diseases. |
Becker 2006,2121 Becker AB, Kuznetsova O, Vermeulen J, Soto-Quiros ME, Young B, Reiss TF, et al. Linear growth in prepubertal asthmatic children treated with montelukast, beclomethasone, or placebo: a 56-week randomized double-blind study. Ann Allergy Asthma Immunol. 2006;96:800-7. Canada, Costa Rica, Hong Kong, South Africa, United States |
Randomized trial (baseline growth data only) |
360 children (6.4-9.4 years) with mild persistent asthma (119 beclomethasone, 120 montelukast, and 121 placeo) |
The percentile for height-for-age (mean ± SD) at study entry in the beclomethasone, montelukast and placebo group was 42.9 ± 26.6, 38.0 ± 27.3, and 43.4 ± 24.9, respectively. |
Pedersen 2007,2222 Pedersen S, Agertoft L, Williams-Herman D, Kuznetsova O, Reiss TF, Knorr B, et al. Placebo-controlled study of montelukast and budesonide on short-term growth in prepubertal asthmatic children. Pediatr Pulmonol. 2007;42:838-43. Denmark |
Randomized trial (baseline growth data only) |
42 children (6-11 years) with mild persistent asthma (37 montelukast and 34 budesonide) |
The percentile for height-for-age (mean ± SD) at study entry was 49.8 ± 25.4 in the montelukast group, and 38.0 ± 27.3 and 54.0 ± 27.9 in the budesonide group. |
Turpeinen 2008,2323 Turpeinen M, Nikander K, Pelkonen AS, Syvänen P, Sorva R, Raitio H, et al. Daily versus as-needed inhaled corticosteroid for mild persistent asthma (The Helsinki early intervention childhood asthma study). Arch Dis Child. 2008;93:654-9. Finland |
Randomized trial (baseline growth data only) |
176 children (5-10 years) with mild persistent asthma (59 continuous budesonide, 58 budesonide/placebo, and 61 disodium cromoglycate) |
The mean height SD score (range) at study entry in the continuous budesonide, budesonide/placebo, and cromone group was 0.04 (-0.32 to 0.54), 0.03 (-0.30 to 0.39), and 0.04 (-0.43 to 0.32), respectively. |