Growth patterns in coeliac disease – a longitudinal study of children aged 0–6 years in Sweden

BACKGROUND: Associations between growth deviations and coeliac disease (CD) in children have been documented, but longitudinal evidence-particularly concerning when such deviations first emerge-is limited. The aim of this study was to investigate the occurrence and timing of growth deviations in relation to CD diagnosis, and to assess whether these patterns differed between boys and girls in a Swedish preschool population. METHODS: This retrospective longitudinal study was conducted as part of the project Evidence based knowledge about deviant growth in children 0-6 years. A total of 185 children with CD were identified through the Regional Healthcare Information Platform. Background characteristics and growth deviations relative to the time of CD diagnosis were analysed using descriptive statistics and tests, including chi square, Mann-Whitney U, one way ANOVA, Kruskal-Wallis, paired t tests, and Wilcoxon signed rank tests. RESULTS: Of the 185 participating children, 64 (34.6%) were boys and 121 (65.4%) were girls. Growth deviations were most pronounced at the time of diagnosis, with mean weight SDS of - 0.54 (± 1.2) and mean height SDS of - 0.48 (± 1.1). No significant sex differences were observed. Children diagnosed between 36 and 48 months exhibited significantly greater negative height SDS deviations at one year and six months prior to diagnosis compared with younger age groups. Significant improvements in both weight SDS and height SDS were observed during the two years following diagnosis and initiation of treatment. CONCLUSION: Growth deviations varied according to age at CD diagnosis, with the most pronounced deviations occurring in proximity to the diagnostic timepoint. Growth improved significantly during the two years following diagnosis. These findings suggest that subtle growth deviations may be detectable years before diagnosis, supporting the clinical value of careful growth monitoring in paediatric care. Further research on the implementation of growth based screening parameters in routine practice is warranted.