Neonatal Anthropometrics and Obesity Treatment Response in Children and Adolescents

Ulrik Lausten-Thomsen,Morten Asp Vonsild Lund,Sara Elizabeth Stinson,Christine Frithioff-Bøjsøe,Louise Aas Holm,Jennifer Lyn Baker,Cilius Esmann Fonvig,Michael Christiansen,Lars Ängquist,Torben Hansen,Jens-Christian Holm

doi:10.1016/j.jpeds.2021.11.014

Abstract

To investigate the relationship between in utero growth conditions, as indicated by neonatal anthropometric measures, and childhood obesity treatment response, to examine the potential usefulness of neonatal anthropometrics as a potential childhood obesity treatment stratification tool. The study included 2474 children and adolescents with obesity (mean age, 11.2years; range, 5.0-18.9years) treated at the Children's Obesity Clinic in Holbæk, Denmark. Treatment response was registered prospectively, and neonatal data were collected from national electronic registers. Birth weight, birth length, birth weight for gestational age, and large for gestational age status were positively associated with the degree of obesity at treatment initiation. After a mean (SD) of 1.27 (0.69) years of enrollment in obesity treatment, the children exhibited a mean reduction of -0.32 (0.50) in body mass index SD score. No significant associations between neonatal anthropometric measures and childhood obesity treatment response were detected. Neonatal anthropometric measures were positively associated with the degree of obesity at treatment initiation but not with response to multidisciplinary treatment of childhood obesity. Individualization of obesity treatment based on neonatal anthropometry does not seem warranted.

Highlights

The present study aimed to explore the relationship between in utero growth conditions, as indicated by neonatal anthropometric measures and subsequent childhood obesity treatment response, to investigate whether neonatal anthropometrics could be used as an independent prognostic marker for treatment response
The participants had a mean age of 11.2 years and a mean BMI SDS of 2.93 corresponding to a mean BMI >99th percentile for age and sex
A 1-unit increase in Birth weight relative to gestational age (BW-GA) was associated with a 0.036-unit higher BMI SDS and being born large for gestational age (LGA) was associated with a 0.111-unit higher BMI SDS at treatment initiation (Table III)

Summary

Methods

The study population consisted of children and adolescents treated according to the Holbæk Obesity Treatment Protocol.[13] The inclusion criteria for this study BMI BW-GA. From the 1Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 2The Children’s Obesity Clinic, Department of Pediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark; 3Department of Biomedical Sciences, 4Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, and 8Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 5Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; 6Department of Pediatrics, Kolding Hospital, Kolding, Denmark; and 7Department for Congenital Disorders, Danish National Biobank and Biomarkers, Statens Serum Institut, Copenhagen, Denmark. The authors declare no conflicts of interest. Large for gestational age PI Ponderal index.

Results

Discussion

Conclusion