ESPE Abstracts (2019) 92 LB-5

Height Curves and Height SDS in ADHD Children Measured Before and After Stimulant Treatment are not Affected - Observation Study in 7172 ADHD Children

Doron Carmi1, Uri Gabbay2,3, Aviva Mimouni-Bloch2,4, BatEl Goldstein5, Lital Keinan-Boker6,7, Stav Bloch2, Joseph Meyerovitch Meyerovitch2,8,9


1Shoham Community Pediatric Center, Shoham, Israel. 2Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3Quality Unit, Rabin Medical Center, Petach Tikva, Israel. 4The Pediatric Neurology and Developmental Unit, Loewenstein Hospital, Raanana, Israel. 5School of Public Health, University of Haifa, Haifa, Israel. 6School of Public Health, University of Haifa, Haifa, Israel. 7Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel. 8Institute for Endocrinology and Diabetes, Petach Tikva, Israel. 9Chief Pediatrician, Community Division, Clalit Health Services, Tel-Aviv, Israel


Background: Attention deficit hyperactivity disorder (ADHD) is a common pediatric disorder with ongoing debate in the literature about its association with growth impairment. Most studies have focused on stimulants treatment effect while others suggested direct effect of ADHD. The present study compared height growth of ADHD children each measured before and after stimulant treatment.

Methods: We conducted historical prospective study based on Israeli largest health services provider (Clalit Health Services, 55% of the total population) database. Inclusion criteria were ADHD children 5-18 years old before treatment that eventually received stimulant medications consumed at least for 2 months and accordingly had documented anthropometrics before and after stimulant treatment. A non-ADHD control group derived from the general population of the same birth cohort ages 5-18 was also retrieved as the basis for local Standard Deviation Score (SDS) calculations. Exclusion criteria were documented co-morbidities in either group. We compared gender specific median height curve of the three groups (ADHD before and after treatment and non-ADHD control). We calculated ADHD heights SDS using the control sample statistics (gender and age specific) and analyzed individual's height SDS difference before and after treatment by t-test.

Results: there were 7172 ADHD and 16240 non-ADHD controls. The height curves were nearly overlapping. There was neither difference between gender specific median height curve of ADHD before treatment, non-ADHD control and ADHD after treatment (in both genders). Analysis of the individual's height SDS differences based on the control sample statistics revealed mean height SDS for HDHD males before treatment of 0.027 and height SDS of -0.046 after treatment, and mean height SDS for HDHD females before treatment of 0.086 and height SDS of 0.030 after treatment.

Discussion and conclusions: The study results support evidence that neither ADHD nor ADHD stimulants treatment nor their combined effect have significant effect on linear growth.

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