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Timing and Magnitude of Peak Body Mass Index and Peak Weight Velocity in Infancy Predict Body Mass Index at 2 Years in a Retrospective Cohort of Electronic Health Record Data - 17/06/23

Doi : 10.1016/j.jpeds.2023.01.021 
Charles T. Wood, MD, MPH 1, , Tracy Truong, MS 2, Asheley C. Skinner, PhD 3, 4, Sarah C. Armstrong, MD 1, 4, Eliana M. Perrin, MD, MPH 5, Jessica G. Woo, PhD 6, 7, Cynthia L. Green, PhD 2, 4
1 Division of General Pediatrics and Adolescent Health and Duke Center for Childhood Obesity Research, Department of Pediatrics, Duke University School of Medicine, Durham, NC 
2 Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 
3 Department of Population Health Sciences, Duke University Medical School, Durham, NC 
4 Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 
5 Department of Pediatrics, Johns Hopkins School of Medicine, and School of Nursing, Baltimore, MD 
6 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 
7 Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 

Reprint requests: Charles Wood, MD, MPH, Division of General Pediatrics and Adolescent Health, Department of Pediatrics, Duke University Medical Center, 3116 N. Duke St, Durham, NC 27704Division of General Pediatrics and Adolescent HealthDepartment of PediatricsDuke University Medical Center3116 N. Duke StDurhamNC27704

Abstract

Objectives

To use growth data from electronic health records to describe and model infant growth (weight velocity and peak body mass index [pBMI]) characteristics.

Study design

We extracted data from all children born at ≥34 weeks of gestation within one health system between 2014 and 2017. After excluding implausible growth data with an algorithm created for childhood growth, we estimated pBMI, peak weight and length velocities, and the odds of obesity at 2 years, adjusted for race, sex, ethnicity, and birth weight, by the magnitude of peak weight velocity, peak length velocity, and pBMI.

Results

Among 6425 children (41% White, 28% Black, 26% other race; 16% Hispanic ethnicity), mean pBMI was 17.9 kg/m2 (SD 1.5) and mean age at pBMI was 9.6 months (SD 2.7). Mean peak weight velocity was 949 g (SD 165) per 2 weeks, and the mean peak length velocity was 3.4 cm (SD 0.3) per 2 weeks. Children with obesity at 2 years (n = 931, 14.5%) were more likely to be Hispanic, had greater peak weight and peak length velocities, and had 2 kg/m2 greater magnitude of pBMI than children without obesity. For each unit increase in pBMI, children had more than 4 times greater odds of obesity at age 2 years.

Conclusions

In a large sample of infants with clinical growth data tracked via electronic health records, we found associations between the magnitude and timing of peak infant BMI and obesity at 2 years of age.

Le texte complet de cet article est disponible en PDF.

Abbreviations : BMI, DUHS, EHR, pBMI, PLV, PWV, RCS, WFL


Plan


 This work was funded with institutional support from the Translating Duke Health initiative. The authors declare that they have no conflicts of interest.
 A subset of this work was presented in a platform session at the Pediatric Academic Societies 2021 virtual meeting.


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