Short course of systemic steroids (SCSS) for respiratory diseases during infancy and final adult height. A 20-year prospective birth cohort study.

<bold>BACKGROUND:</bold> SCSS are the cornerstone of effective treatment for many common pediatric respiratory conditions and are considered not to have systemic adverse effects. However, uncertainties remain, particularly as far as growth outcome and bone density are concerned. <bold>OBJECTIONS:</bold> The aim of this study was to record the use of SCSS since birth and to consistently follow the growth of otherwise healthy children until early adulthood. <bold>METHODS:</bold> 261 subjects(male 48.65%)were evaluated and were divided in 4 groups according to SCSS administration. Group A included cases that have never received systemic steroids. Group B consisted of patients that have been prescribed SCSS during infancy only(<3 years old). Group C consisted of cases that used SCSS during infancy and preschool years only, whereas Group D included children that used SCSS during infancy and up to adulthood. <bold>RESULTS:</bold> There was no difference among the different groups as far as age and sex are concerned. Boys reported twice as many days of SCSS use than girls and total days of therapy were negatively related to final height. No significant difference was detected for final height among boys or girls in groups A and B. However boys that belong to Group C and D were 4 and 5 cm shorter respectively, than boys in groups A and B. Both sexes than received SCSS during infancy were 1.7-2.5 cm, even non- significant, shorter than cases who never received. <bold>CONCLUSIONS:</bold> The use of SCSS merely during infancy had a minor impact on final height. Males with persistent use had significant lower final height and total days of treatment had an added inverse correlation. More studies are needed to clarify these results.