232 - Current weight status of sexually assaulted pediatric female patients in an emergency department setting.

Poster Number: 232
Publication Number: 232.402

Elizabeth A. Camp, Baylor College of Medicine, Houston, TX, United States; Marcella Donaruma, Baylor College of Medicine, Houston, TX, United States; Christopher Greeley, Baylor College of Medicine, Houstont, TX, United States; Reena Isaac, Baylor College of Medicine, Houston, TX, United States

Background: There is evidence showing that childhood sexual abuse (CSA) can lead to adult obesity. However, the relationship between childhood obesity (CO) and CSA is less clear with studies reporting conflicting results. Further research is needed in pediatric patients living with obesity and the possibility of previous or ongoing sexual abuse.

Objective: This study aims to assess the association between female pediatric patients' weight status during Emergency Department (ED) evaluation and the odds of suspected CSA when compared to trauma patients who were admitted to the ED during the same time period.

Design/Methods: This is a single-center, retrospective case-control study that utilized pediatric ED data (2016 – 2018) from identified female patients with a chief complaint of sexual assault and female trauma registry patients, both aged 6 – 17 years old. Two weight measurements were calculated based on available height data: body mass index (BMI)-for-age and weight-for-age. For any patients who were missing height data, charts were reviewed to acquire height data collected ±30 days from ED arrival. A minimum of 340 patients were estimated to achieve 80% power. Non-parametric testing (Pearson Chi-Square and Mann-Whitney tests) were utilized for descriptive comparisons between groups. Unadjusted (OR) and adjusted (aOR) odds ratios were provided. To adjust for potential confounders, binary logistic regression was utilized.

Results: Overall, there were 2,044 study participants: 1454 (71.1%) cases and 590 (28.9%) controls. There were significant differences between cases and controls for all demographic factors (all p-values < 0.001). Cases were older, underrepresented minorities (URM) and had public insurance. Also weight and height data (along with subsequent calculations) were higher for cases. Using the BMI-for-age metric, patients with CO had a 67% increased odds for CSA after adjusting for minority status, insurance and age (aOR = 1.67 (95% CI 1.07 – 2.62); p-value = 0.03); while the weight-for-age metric increased the adjusted odds by only 58% (aOR = 1.58 (95% CI 1.14 – 2.17); p-value = 0.01) when compared to pediatric trauma patients. A potential trend was observed with odds increasing for CSA as weight status increased.Conclusion(s): Our data demonstrate an association between CO and evaluation for suspected CSA. It appears that the odds for CSA increases as weight status increases, however it is unclear if that association exists in other pediatric populations. More research is needed to identify the biopsychosocial implications for this relationship and the potential to augment clinical care.
Table 1. Demographic and clinical comparisons between cases and controls in females aged six years and older (N = 2044).Table 1.jpeg
Table 2. Unadjusted and adjusted associations for weight status in sexually assaulted female patients aged six years and older.Table 2.jpeg