Physical Growth and Its Determinants in Indian Children with Down Syndrome, from 3 Months to 5 Years of Age.

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.