O0003: Weight-for-length Percentile, Weight-for-age Percentile, and BMI in Children Younger Than 2 Years of Age in Predicting the Development of Overweight and Obesity in Children

Background: Obesity in children and adolescents has worldwide more than doubled since 1980 leading to emergence of comorbidities. Early detection and intervention are important in preventing complications from obesity, however, there is no accepted anthropometric measurement to define excess adiposity in children under 2 years.
The purpose of this study is to evaluate weight-for-length percentile, weight-for-age percentile, and BMI in children less 2 years old in predicting the development of overweight and obesity in children 2, 3, and 4 years old.

Methods: A retrospective cohort study of children born at University of South Alabama Children’s and Women’s Hospital from May 2011 to October 2013. Included participants had at least one well child visit between ages 2 to 18 months and at least one well child visit between ages 2 to 4 years old. Preterm birth, small for gestational age, and patient with comorbidities affecting growth were excluded from the study.
All collected data were organized in an Excel spreadsheet and analyzed using statistical software JMP v 15.2.0. Logistic regression was used to identify predictors of childhood overweight obesity.

Results: There were 1,178 children identified by ICD codes. A total 612 children met inclusion and exclusion criteria. Included patients were 52% male and 48% female, 81% African American and 19% non-African American, 70% formula fed, 14% breastfed and 16% both formula fed and breastfed, and 91% low socioeconomic status.
At 2 years of age, logistic fit showed significant association between overweight and obesity at this age and each of the following: weight-for-age percentile at 18 months (Log worth = 3.417, p = 0.00034), BMI at 18 months (Log worth = 2.318, p = 0.00481), and weight-for-age percentile at 12 months (Log worth = 1.633, p = 0.02326).
At 3 years of age, logistic fit showed significant association between overweight or obesity at this age and BMI at 18 months (Log worth = 2.759, p = 0.00174).
At 4 years of age, logistic fit showed significant association between overweight and obesity at this age and the following: BMI at 18 months (Log worth = 2.520, p = 0.00302) and weight-for-length percentile at 6 months (Log worth = 1.594, p = 0.02549).

Conclusion: Childhood overweight and obesity at age 2, 3 and 4 years are associated with BMI at 18 months of age.
Diagnosis of overweight and obesity at 18 months of age using BMI should be considered for early detection and intervention to prevent complications of obesity in late childhood and adulthood.