145 - A Hidden Epidemic: Prevalence of Obesity and Overweight among Children with Medical Complexity

Poster Number: 145
Publication Number: 145.305

Maria I. Peinado Fabregat, Stanford University School of Medicine, Stanford, CA, United States; Olga Saynina, Stanford University School of Medicine, Palo Alto, CA, United States; Lee Sanders, Stanford University, Stanford, CA, United States

Background: Children with medical complexity (CMC) account for a disproportionate share of child healthcare use, concentrated in subspecialty care centers. One in 3 US children is overweight or obese. While improved CMC care requires a better understanding of preventable co-morbidities, no prior studies have examined the prevalence of overweight and obesity among CMC.

Objective: Assess the relative prevalence of overweight or obesity among CMC, compared with children without medical complexity, and explore potentially modifiable mechanisms for this relationship.

Design/Methods: Retrospective cohort of all children ages 2 -18 seen for ambulatory care in 2019 at a single academic medical center, for whom there was a valid weight and height recorded at a single visit. Primary outcome was overweight or obesity, defined as BMI > 84% for age and sex (CDC growth curves). CMC were defined by ≥1 serious chronic condition, by a standardized set of ICD-10 diagnostic codes (Feudtner 2014). Multivariable logistic regression was used to adjust for common confounders (age, sex, race, ethnicity, parent preferred language, insurance type).

Results: Of 42,199 children, 29.7% were CMC. Overweight or obesity prevalence was higher for CMC than non-CMC (32.7% vs 18.4% p=Conclusion(s): CMC are significantly more likely to be overweight or obese, when compared to children without medical complexity. Risk factors, such as parent language and diagnostic category, suggest potential targets for early intervention to prevent weight-related comorbidities for this vulnerable population.
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Table 2. Multi-variable analysis: Characteristics associated with child overweight or obesity.