P0206 - Familial and Sociodemographic Factors Affecting the Age of Onset of Childhood Obesity

Introduction:
Prevention is the key to success for childhood obesity. Management of obesity is difficult and frequently unsuccessful while prevention of childhood obesity can provide a better chance for reducing long-term complications. While most interventions have been aimed at school-aged children, recent evidence suggests that intervention may be more effective at even earlier ages. We sought to define the relationship between key familial and sociodemographic factors and the age of onset of childhood obesity.

Methods:
All children born at our institution between January 2004 and November 2017 that had body mass index (BMI) measured between the ages of 3 – 12 years old were included in the study. Children whose mothers were not seen at our institution and did not have patient data were excluded. The initial age of obesity was defined as the age at the first encounter where a child had a BMI  95th percentile for age and sex. Subjects were censored at last encounter or at age 12, whichever came first. We modeled the time from birth to obesity using Cox Proportional Hazards models.

Results:
A total of 5,723 children were included in the study. 1290 (22.5%) were obese and 4433 (77.5%) non-obese. 2847 (49.8%) children were female, 739 (12.9%) identified as Black, 3397 (59.4%) as Hispanic, 1323 (23.1%) as White, and the remaining 264 (4.6%) as Other. The mean (st.deviation) age at first obese encounter was 6.3 (3.1) years. Factors that significantly resulted in earlier age of obesity onset were higher birthweight (p<0.0001), higher maternal BMI (p<0.0001), Hispanic race (compared to White race, p=0.0087), and the presence of maternal postpartum depression (p=0.043). Later age of onset of obesity was significantly associated with female sex (p=0.047), maternal marital status as married (compared to unmarried, p=0.037), and maternal marital status as unknown (compared to unmarried, p=0.0006). Non-contributory factors included patient insurance status, maternal age at patient’s birth, and maternal preferred language.

Conclusion:
Earlier onset of obesity was significantly associated with higher birthweight, higher maternal BMI, Hispanic race, and the presence of maternal postpartum depression while later age of onset of obesity was significantly associated with female sex and maternal marital status as married or unknown. These results provide the opportunity to develop targeted interventions towards high risk populations at earlier ages.