Departments of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Departments of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Pediatr. 2022 Feb;89(2):141-147. doi: 10.1007/s12098-021-03864-9. Epub 2021 Aug 19.
To compare the growth of Indian children with Down syndrome (DS), with typically developing Indian children. The effect of comorbidities on their physical growth was also evaluated, so that factors affecting growth can be identified early and timely interventions be planned.
A cross-sectional study was conducted at the All India Institute of Medical Sciences, New Delhi from June 2015 to June 2017. Children with karyotype-proven DS within age group of 3 mo to 5 y were enrolled as study subjects. Children with DS having mosaic karyotype were excluded. Anthropometry and associated comorbidities were assessed.
Hundred and eight children with DS were enrolled, mean WHO z scores were-WAZ: -2.31 (SD 1.44), HAZ: -2.51 (SD 1.47), BAZ: -1.07 (SD 1.8), and HCZ: -2.79 (SD 1.21). Congenital heart disease (in 44.5% children), hypothyroidism (in 27.7%), and anemia (in 50%) were the common comorbidities. Growth parameters of children with and without any comorbidity were significantly different, mean WHO z scores were WAZ -2.61 vs. -1.09 (p = 0.005), HAZ -2.43 vs. -2.41 (p = 0.3), BAZ -1.49 vs. -0.38 (p = 0.001), and HCZ -3.13 vs. -2.33 (p = 0.001).
Growth of Indian children with DS is significantly less compared to normally growing children. Weight was affected maximum during infancy, length was more affected as the age progressed, head circumference was affected similarly in all age groups, whereas BMI showed almost progressive increase with age. Children with severe heart disease had significantly lower BMI whereas children with treated hypothyroidism had better growth. There is a need for a large longitudinal study on Indian children with DS to construct Indian DS-specific growth charts.
比较唐氏综合征（DS）患儿与印度正常儿童的生长情况。还评估了合并症对其体格生长的影响，以便及早识别影响生长的因素并及时制定干预措施。
本横断面研究于 2015 年 6 月至 2017 年 6 月在印度新德里全印度医学科学研究所进行。纳入年龄在 3 个月至 5 岁之间、经核型证实为 DS 的患儿作为研究对象。排除核型为嵌合体的 DS 患儿。评估患儿的人体测量学指标和相关合并症。
共纳入 108 例 DS 患儿，其 WHO z 评分均值为 WAZ：-2.31（标准差 1.44）、HAZ：-2.51（标准差 1.47）、BAZ：-1.07（标准差 1.8）和 HCZ：-2.79（标准差 1.21）。常见的合并症有先天性心脏病（44.5%的患儿）、甲状腺功能减退症（27.7%）和贫血（50%）。有或无任何合并症的患儿其生长参数差异有统计学意义，其 WHO z 评分均值分别为 WAZ：-2.61 与-1.09（p=0.005）、HAZ：-2.43 与-2.41（p=0.3）、BAZ：-1.49 与-0.38（p=0.001）和 HCZ：-3.13 与-2.33（p=0.001）。
与正常生长的儿童相比，印度 DS 患儿的生长明显较差。体重在婴儿期受影响最大，随着年龄的增长，身高受影响更大，头围在所有年龄组均受相似影响，而 BMI 则随年龄的增长呈几乎持续增加的趋势。患有严重心脏病的患儿 BMI 明显较低，而接受治疗的甲状腺功能减退症患儿生长情况较好。需要对印度 DS 患儿进行大型纵向研究，以制定印度 DS 特异性生长图表。
