A new study has found for the first time that as Americans are gaining more body fat, so are their babies. The research, which reviewed data from more than 74,000 births, found that a key measure of body fat composition in newborns increased significantly over a 15-year period, mirroring similar increases among pregnant mothers. The findings were presented Sunday by researchers from Children's Mercy Hospitals and Clinics at the Pediatric Academic Societies annual meeting.
According to the study, as the body mass index of pregnant mothers increased from the years 1990 to 2005, so did a measure of body fat composition in newborns known as the ponderal index. The ponderal index is a measure of body mass index for the newborn – a higher birth ponderal index means the child's body may be composed of more fat.
"Health care providers need to pay closer attention to the body mass index of women before they get pregnant, and equal attention to how much weight they gain during the pregnancy," said lead investigator Felix Okah, MD, MS, professor of pediatrics and director, Neonatal-Perinatal Medicine Fellowship Program, Children's Mercy Hospitals and Clinics. "Adult diseases like obesity may have their foundation during the fetal period, so efforts to safeguard the health of the fetus could translate to future adult health for these newborns."
Obesity has emerged as a serious public health problem in the United States. The trend is reflected in a heavier body mass index among women getting pregnant, which is particularly troubling because it can contribute to complications during pregnancy, and may set the stage for future obesity in the child.
Clinical investigators from Children's Mercy presented a total of 40 studies at the Pediatric Academic Societies meeting. Other key studies presented include:
Pulmonary Function and Exercise Capacity in Children Born Preterm
May 3 Oral Presentation, Course 3495
This study found that long-term lung function needs to be monitored for all premature babies, not just those born severely early or underweight, as was previously thought.
According to the research, older children born only mildly preterm and not severely underweight had lung function measures comparable to their peers born extremely preterm and with severely low birth weight.
Previous studies have demonstrated that extremely preterm and low birth weight babies grow into children and adults with decreased lung function and oxygen consumption measurements – suggesting a poor level of fitness – compared to full-term babies.
"We expected there would be more lung function abnormalities in the most extreme preterm infants, since they had more opportunity for lung injury immediately after birth," said lead investigator Howard Kilbride, MD, section chief, Neonatology, Children's Mercy Hospitals and Clinics. "However, our findings indicate that long-term lung function outcomes need to be assessed for all preterm infants, not just those with extreme low birth weight or severe neonatal lung disease."
Correlates of Success in the Promoting Health in Teens and Kids (PHIT Kids) Program
May 4 Poster Presentation, Course 4404, Board 213
This study found that efforts to fight childhood obesity are more likely to be successful when parents lead the way. Families that participated in a six-month weight loss program were nearly twice as likely to see meaningful weight loss in their children when the parents also lost weight.
Children participating in the program generally demonstrated statistically significant improvements in body mass index (BMI) z-scores, HDL (good) cholesterol and triglycerides, but the BMI results were most dramatic in families where the parents lost weight as well.
"Parents are their child's best role model – the gatekeepers and the gateways – to better health," said Sarah Hampl, MD, Medical Director, Weight Management Services at Children's Mercy Hospitals and Clinics. "Change is difficult to make and sustain in isolation, especially for kids. Children need the support of their parents and other family members who are eating healthier and getting more physical activity together."
The study evaluated families participating in the Children's Mercy Promoting Health in Teens and Kids (PHIT Kids) program, which serves obese 9-18 year olds and their parents or caregivers with a culturally tailored, behaviorally-based group intervention consisting of weekly sessions followed by monthly sessions for a total of 24 months.
Clinical and Genetic Predictors of Methotrexate Polyglutamate Patterns in Juvenile Idiopathic Arthritis
May 4 Oral Presentation, Course 4125
This study found that it may be possible to predict in advance how effective treatment for a relatively common type of childhood arthritis will be by using a test to measure how the drug is broken down within a patient's cells.
The condition, known as juvenile idiopathic arthritis, results in chronic joint pain and swelling and can interfere with a child's normal growth and development if left untreated. But it can take months before anyone knows whether methotrexate, a key treatment for the condition, is working. Patients risk unnecessary exposure to potential serious side effects in the meantime. In this study, a child's genetics were shown to impact how the drug was metabolized, as did the way the drug was administered.
"Understanding what causes methotrexate to be processed differently in patients – and what that means for how well treatment will work – will allow a more personalized approach to dosing this medication in children," said Mara L. Becker, MD, MSCE, Pediatrics, Clinical Pharmacology/Rheumatology, Children's Mercy Hospitals and Clinics. "This drug is used for a variety of conditions, so the findings have the potential to also affect patients with cancer, or certain skin or stomach conditions."
Children's Mercy Hospitals and Clinics