The relationship between body mass index and children’s presentations to a tertiary pediatric emergency department

Ferro, Valentina; Mosca, Antonella; Crea, Francesca; Mesturino, Maria Alessia; Olita, Carla; Vania, Andrea; Reale, Antonino; Raucci, Umberto

doi:10.1186/s13052-018-0476-y

Cited by 11 publications

(8 citation statements)

References 28 publications

(29 reference statements)

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“…The evidence regarding a link between obesity and risk of accidents remains inconclusive. Whereas Lynch et al 23 reported that obesity seemed to increase such risk, Ferro and colleagues30 concluded that obesity played a protective role. Such role, however, probably reflects the inverse relationship between obesity and physical activity levels among children.…”

Section: Discussionmentioning

confidence: 99%

Demand for health services and drug prescriptions among overweight or obese preschool children

et al. 2019

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ObjectivesTo evaluate the association between excess weight and the demand of health services in preschool children compared with healthy weight.MethodsThe data come from the Longitudinal Study of Childhood Obesity cohort (1884 4-year-old children, residing in the Madrid region, Spain) who provided information through telephone questionnaire, physical examination and electronic medical records. We defined overweight, general and abdominal obesity based on body mass index, waist circumference and waist-to-height ratio. Using mixed models of multivariable negative binomial regression we calculated the incidence rate ratio (IRR) regarding primary care (PC) doctor visits, drug prescriptions and hospital admissions by weight status at the end of the 2-year follow-up.ResultsChildhood general obesity was associated with a higher demand for PC services related to psychological problems (IRR=1.53; 95% CI 1.02 to 2.28) and childhood abdominal obesity, according to waist-to-height ratio, was related to more frequent problems of the musculoskeletal system (IRR=1.27; 95% CI 1.00 to 1.62). Drugs were prescribed more frequently to children falling under all three definitions of excess weight, compared with healthy weight children. No differences in the number of hospital admissions were observed.ConclusionsThe demand of health services related to early childhood obesity was small. Nevertheless, obesity was associated with a slightly greater demand for drug prescriptions and for PC doctor visits related to psychological and musculoskeletal problems.

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Section: Discussionmentioning

confidence: 99%

Demand for health services and drug prescriptions among overweight or obese preschool children

et al. 2019

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“…Chronic kidney disease, low bone mineral density, glucocorticoid use, vitamin D deficiency, and dietary factors have been implicated in the pathophysiology of fracture . Vitamin D deficiency has been associated with childhood obesity, obesity being implicated in pediatric fracture pathophysiology in retrospective clinical and basic science studies …”

Section: Introductionmentioning

confidence: 99%

“…(17)(18)(19)(20)(21)(22) Vitamin D deficiency has been associated with childhood obesity, obesity being implicated in pediatric fracture pathophysiology in retrospective clinical and basic science studies. (23)(24)(25)(26)(27)(28)(29)(30)(31) Less evidence exists for the impact of preschool obesity upon future health, with previous studies including a wide age range of children producing conflicting results. (32) A focused study of the association between preschool obesity and fracture risk offers the opportunity to better understand the impact of obesity in early life.…”

Section: Introductionmentioning

confidence: 99%

Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow-up in Catalonia, Spain

Lane

Butler

Poveda-Marina

et al. 2020

Journal of Bone and Mineral Research

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This study aimed to determine if having an overweight or obese range body mass index (BMI) at time of beginning school is associated with increased fracture incidence in childhood. A dynamic cohort was created from children presenting for routine preschool primary care screening, collected in the Information System for Research in Primary Care (SIDIAP) platform in Catalonia, Spain. Data were collected from 296 primary care centers representing 74% of the regional pediatric population. A total of 466,997 children (48.6% female) with a validated weight and height measurement within routine health care screening at age 4 years (±6 months) between 2006 and 2013 were included, and followed up to the age of 15, migration out of region, death, or until December 31, 2016. BMI was calculated at age 4 years and classified using WHO growth tables, and fractures were identified using previously validated ICD10 codes in electronic primary care records, divided by anatomical location. Actuarial lifetables were used to calculate cumulative incidence. Cox regression was used to investigate the association of BMI category and fracture risk with adjustment for socioeconomic status, age, sex, and nationality. Median follow‐up was 4.90 years (interquartile range [IQR] 2.50 to 7.61). Cumulative incidence of any fracture during childhood was 9.20% (95% confidence interval [CI] 3.79% to 14.61%) for underweight, 10.06% (9.82% to 10.29%) for normal weight, 11.28% (10.22% to 12.35%) for overweight children, and 13.05% (10.69% to 15.41%) for children with obesity. Compared with children of normal range weight, having an overweight and obese range BMI was associated with an excess risk of lower limb fracture (adjusted hazard ratio [HR] = 1.42 [1.26 to 1.59]; 1.74 [1.46 to 2.06], respectively) and upper limb fracture (adjusted HR = 1.10 [1.03 to 1.17]; 1.19 [1.07 to 1.31]). Overall, preschool children with an overweight or obese range BMI had increased incidence of upper and lower limb fractures in childhood compared with contemporaries of normal weight. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.

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“…An Italian study found that obese children have an increased fracture risk at ages 6-12 years. The authors suspect reduced bone density as a result of reduced physical activity, biomechanical factors, and vitamin D deficiency to be the reason for the increased fracture risk (Ferro et al 2018). However, a Danish study found that the prevalence rates of obesity among children have plateaued and even shown a tendency for decline 1983, 1997, Hedström et al 2010, Rennie et al 2007, Meling et al 2009, Lempesis et al 2017.…”

Section: Discussionmentioning

confidence: 99%

Development of the annual incidence rate of fracture in children 1980–2018: a population-based study of 32,375 fractures

et al. 2020

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Background and purpose — Pediatric fractures are a common cause of morbidity. So far, no larger Danish study has described the development in the incidence rates. Therefore, we describe the development in the incidence rates of pediatric fractures in the time period 1980–2018 and the frequency of the most common type of fractures. Patients and methods — This is a retrospective register study of all children aged 0–15 years with a fracture treated in the Emergency Department at Odense University Hospital, Denmark, between 1980 and 2018. For all cases, information on age, sex, date of treatment, diagnosis, and treatment was obtained from the patient registration system. Based on official public population counts we estimated age and sex-specific annual incidence rates. Results — 32,375 fractures were included. In the study period the incidence rate decreased by 12%. The incidence increased until the early 1990s. Thereafter incidence rates decreased until 2004–09, from then onward increasing towards the end of the study period. The highest age-specific incidence rate in boys of 522 per 10,000 person-years was at 13 years of age. In girls the age of the highest incidence rate decreased from 11 years in 1980 to 10 years in 2018. Fracture of the lower end of the forearm, the clavicle, and the lower end of the humerus had the highest single fracture incidence rates. Interpretation — The incidence rate of pediatric fractures decreased in the study period by 12%. The highest single fracture incidence rates were for fracture of the lower end of the forearm, the clavicle, and the lower end of the humerus. As the first longitudinal Danish study of pediatric fractures this study is a baseline for evaluating future interventions and future studies.

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The relationship between body mass index and children’s presentations to a tertiary pediatric emergency department

Cited by 11 publications

References 28 publications

Demand for health services and drug prescriptions among overweight or obese preschool children

Demand for health services and drug prescriptions among overweight or obese preschool children

Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow-up in Catalonia, Spain

Development of the annual incidence rate of fracture in children 1980–2018: a population-based study of 32,375 fractures

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