Objective To examine the association between maternal prepregnancy obesity and cognitive test scores of children at early primary school age. Methods A descriptive observational design was used. Study subjects consist of 3412 US children aged 60 to 83 months from the National Longitudinal Survey of Youth 1979 Mother and Child Survey. Cognitive test scores using the Peabody Individual Achievement Test reading recognition and mathematics tests were used as the outcomes of interest. Association with maternal prepregnancy obesity was examined using the ordinary least square regression controlling for intrauterine, family background, maternal and child factors. Results Children of obese women had 3 points (0.23 SD units) lower PIAT reading recognition score (p=0.007), and 2 points (0.16 SD units) lower PIAT mathematics scores (p<.0001), holding all other factors constant. As expected, cognitive test score was associated with stimulating home environment (reading: β=0.15, p<.0001, and math: β=0.15, p<.0001), household income (reading: β=0.03, p=0.02 and math: β=0.04, p=0.004), maternal education (reading: β=0.42, p=0.0005, and math: β=0.32, p=0.008), and maternal cognitive skills (reading: β=0.11, p<.0001, and math: β=0.09, p<.0001). Conclusion There was a significant association between maternal prepregnancy obesity and child cognitive test scores that could not be explained by other intrauterine, family background, maternal, and child factors. Children who live in disadvantaged postnatal environments may be most affected by the effects of maternal prepregnancy obesity. Replications of the current study using different cohorts are warranted to confirm the association between maternal prepregnancy obesity and child cognitive test scores.

Background and purpose More nurse practitioners (NPs) infiltrate into primary care settings, and play a pivotal role in prevention of childhood obesity. However, minimal research has been published about their practice patterns. The current study uses a sample of Ohio NPs and describes NPs’ childhood obesity prevention practice patterns, knowledge of the guidelines, their personal physical activity in relation to childhood obesity prevention practices, and identification of perceived barriers for practice. Method Mail surveys were sent to a random selection of Ohio NPs. Quantitative and qualitative analyses methods were used to analyze the association between NPs’ personal physical activity and their practice patterns and barriers to preventive practices related to childhood obesity. Conclusions Ohio NPs who reported engaging in higher physical activity levels were more likely to report providing frequent assessment and counseling of healthy diet and physical activity. Frequency of weight tracking and referral to specialists were less frequent regardless of physical activity engagement by the NPs. Parental resistance was the most significant barrier to lifestyle counseling. Implications for practice Findings from the current study may offer new insight into innovative approaches for treatment and prevention of childhood obesity. These may include simple quality improvement projects to advocacy for community and school programs.

No abstract

No abstract

No abstract

Objectives This study examined the impact of the Expert Committee Recommendations (ECR) on childhood obesity preventive care during well-child visits in the United States. Methods Data from the 2006-2009 NAMCS and NHAMCS-OPD were used to examine frequencies of diet/nutrition and exercise counseling during well-child visits by children aged two to 18 years. Differences in rates of the counseling before and after the ECR were compared. Results Only 37% and 22% of all visits in 2006-2007 and 33% and 18% in 2008-2009 were provided with diet/nutrition and exercise counseling, respectively. The frequencies of the counseling among those with obesity diagnosis showed no change. Socioeconomically disadvantaged children received the counseling less frequently after the ECR. Conclusion Overall, rates of obesity preventive care were low in all years, with no evidence of improvement with the ECR. Systematic approaches are needed to improve delivery of obesity preventive care irrespective of socioeconomic backgrounds of children.

No abstract

Objective Evidence for the adverse effects of prepregnancy obesity on offspring’s neurodevelopmental outcomes has begun to emerge. We examined the association between prepregnancy obesity and children’s behavior problems and if the association would differ by race. Methods This observational study used a total of 3395 White (n = 2127) and African American (n = 1268) children aged 96 – 119 months from the National Longitudinal Survey of Youth. Behavior Problem Index (BPI) total and subscale scores were used to measure children’s behavior problems. The association between maternal prepregnancy obesity and the BPI scores for each racial group was examined using multivariate linear and logistic regressions, controlling for prenatal, child, maternal, and family background factors. Results Maternal prepregnancy obesity was independently associated with an increase in the BPI total scores among the White sample only. Among the African Americans, prepregnancy obesity was not associated with the BPI scores. Subsample analyses using externalizing and internalizing subscales also revealed similar trends. Among the White sample, children born to obese women were more socially disadvantaged than those born to non-obese women, whereas no such trend was observed in children of African American obese and non-obese women. Conclusion The impact of maternal prepregnancy obesity on children’s behavior problems differed by racial groups. Obesity-related metabolic dysregulations during the intrauterine period may not contribute to later children’s behavior problems. Social and psychological factors seem to play key roles in the association between prepregnancy obesity and childhood behavior problems among Whites.