Nutritional status and growth of children with hemophilia: a cross-sectional study

Gayathri Devi Chinnappa, Venugopal S., Meera Varadarajan, Mallesh Kariyappa, Smitha R.


Background: Haemophilia A and B are the most common severe bleeding disorders and are inherited as X linked recessive pattern. The main clinical manifestations include bleeding into musculoskeletal sites or soft tissues mainly causing joint impairment and thus resulting in various morbidities. Prophylaxis therapy and inhibitor management have contributed a lot to the management of haemophilia cases. However in resource poor setting countries, like India, availability of factors, prophylactic therapy is farfetched leading to joint abnormalities, decreased physical activity and thus leading to different nutritional states. Studies from developed countries reveal obesity and overweight instances in children with Hemophilia. However not many studies have been undertaken to evaluate the nutritional status of such children in India.

Methods: This study was conducted in the Comprehensive hemophilia Care Centre, Victoria Hospital, attached to Bangalore Medical College. A total of 50 children were included in the study. Children aged between 4 and 18 years attending the hemophilia Clinic were included in the study. Observations and review of relevant documents were done.

Results: Among 50 children of haemophilia, 18(36%) children were aged less than 10 years and 32(64%) children were aged more than 10 years. The mean age of onset of disease in haemophilia A was 27.5 months (SD of 24.84; range 6-120) and in haemophilia B was 8 months (SD of 2.72; range 3-12). The mean BMI among children aged more than 10 years was more (21.35; SD= 4.02) compared to the children less than 10 years (16.87; SD= 3.41).

Conclusions: The prevalence of overweight and obesity among children with Haemophilia is more in adolescent age group compared to children in the first decade.


Body mass index, Haemophilia, Malnutrition, Nutritional status, Obesity

Full Text:



Karim MA, Jamal CY. A review on hemophilia in children. Bangl J Child Health. 2013;37(1):27-40.

Ghany HM, Hassab HM, El-Noueam KI. Hemophilic arthropathy: clinical, radiologic, and functional evaluation: a single-center experience in a limited resource country. Egypt Rheumatol Rehabilitat. 2016 Jan 1;43(1):35.

Knobe K, Berntorp E. Haemophilia and joint disease: pathophysiology, evaluation, and management. J Comorbid. 2011;1(1):51-9.

Chang CY, Li TY, Cheng SN, Pan RY, Cheng CN, Wang HJ, et al. Obesity and overweight in patients with hemophilia: Prevalence by age, clinical correlates, and impact on joint bleeding. J Chin Medi Assoc. 2019 Apr 1;82(4):289-94.

Berntorp E. Joint outcomes in patients with haemophilia: the importance of adherence to preventive regimens. Haemoph. 2009;15(6):1219-27.

Srivastava A. Factor replacement therapy in haemophilia–are there models for developing countries?. Haemophilia. 2003 Jul;9(4):391-6.

Chuansumrit A. Treatment of haemophilia in the developing countries. Haemoph. 2003 Jul;9(4):387-90.

De Kleijn P, Van Genderen FR, Van Meeteren NL. Assessing functional health status in adults with haemophilia: towards a preliminary core set of clinimetric instruments based on a literature search in Rheumatoid Arthritis and Osteoarthritis. Haemophilia. 2005 Jul;11(4):308-18.

Soucie JM, Wang C, Siddiqi A, Kulkarni R, Recht M, Konkle BA, Hemophilia Treatment Center Network. The longitudinal effect of body adiposity on joint mobility in young males with Haemophilia A. Haemophilia. 2011 Mar;17(2):196-203.

Centers for Disease Control and Prevention. UDC: The Universal Data Collection Program. Report on the Universal Data Collection Program; 2005.

Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight & obesity in India: A systematic review. Ind J Medi Res. 2016 Feb;143(2):160.

Majumdar S, Morris A, Gordon C, Kermode JC, Forsythe A, Herrington B, et al. Alarmingly high prevalence of obesity in haemophilia in the state of Mississippi. Haemophilia. 2010 May;16(3):455-9.