Infant Obesity and Severe Obesity Growth Patterns in the First Two Years of Life

Abstract

Distinguishing an obesity growth pattern that originates during infancy is clinically important. Infancy based obesity prevention interventions may be needed while precursors of later health are forming. Infant obesity and severe obesity growth patterns in the first 2-years are described and distinguished from a normal weight growth pattern. A retrospective chart review was conducted. Body mass index (BMI) growth patterns from birth to 2-years are described for children categorized at 5-years as normal weight (n = 61), overweight (n = 47), obese (n = 41) and severely obese (n = 72) cohorts using WHO reference standards. BMI values were calculated at birth, 1-week; 2-, 4-, 6-, 9-, 12-, 15-, 18-months; and 2- and 5-years. Graphs of the longitudinal Analysis of Variance of Means of BMI values identified the earliest significant divergence of a cohort's average BMI pattern from other cohorts' patterns. ANOVA and Pearson Product Moment correlations were also performed. Statistically significant differences in BMI values and differences in growth patterns between cohorts were evident as early as 2-6 months post-birth. Children who were obese or severely obese at 5-years demonstrated a BMI pattern that differed within the first 2-years of life from that of children who were normal weight at 5-years. The earliest significant correlation between early BMI values and 5-year BMI value was at 4-months post-birth. The study fills an important gap by demonstrating early onset of an infant obesity growth pattern in full-term children who were healthy throughout their first 5 years of life.

BMI Trajectories from Birth to Young Adulthood

“…Much of the work to date has focused on the importance of early childhood, as rapid weight gain during this period has been linked to later obesity . Though our study did demonstrate BMI trajectory differences present in young childhood, a result that is in keeping with previous work , we did not detect differences in the rate of BMI increase (slope trajectory) during this period. However, more surprising was the divergence in slopes between those with severe obesity and those who did not meet the severe obesity threshold beginning at age 12 and reaching statistical significance at age 14.…”

Infant Growth following Maternal Participation in a Gestational Weight Management Intervention

“…Both of these measures have been studied previously and have been associated with developing obesity at 5-10 years of age. 22,23 To assess crossing WFL percentiles, we followed the method used by Taveras and colleagues. 22 In other words, we considered infants who crossed two major percentiles on the 2000 CDC growth curves within a 6-month window to be high risk for subsequent obesity.…”

“…Peak BMI of 17 kg/m 2 or greater has been associated with subsequent obesity in a retrospective case-control study. 23 These data were available for all infants.…”

Obesity Prevention in Children from Birth to Age 5

“…9,[17][18][19] First-year weight gain in low-birth-weight infants also predicted the development of obesity by 8 years of age. 20 Appropriate weight-for-gestational age children who displayed rapid weight gain in infancy had a greater risk of being overweight or obese during childhood than children who did not experience rapid weight gain post-birth.…”