Looking at the tiniest babies in the neonatal intensive care unit at Jefferson – those who weigh less than two pounds and seem like you could hold them in the palm of your hand – it’s hard to imagine any of them weighing too much.
Those extremely low birthweight newborns are at such high risk of a host of health issues from asthma to neurological delays that obesity is not on the radar. In fact, most of us and most parents of these children are focused on helping these children gain weight.
A recent study in the Journal of the American Medical Association (JAMA), however, suggests that by the age of 14 those babies become obese at the same rate as their normal birthweight peers.
“It is counterintuitive when you first hear it,” said Sandra G. Hassink, MD, FAAP, an assistant professor of pediatrics at Thomas Jefferson University and Director of the Nemours Obesity Initiative at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del. But the study is a reminder to clinicians, and for parents of these children it provides some additional information and a “chance to be proactive…and contribute to the overall health and well-being of the child no matter where the child is finding themselves, no matter what chronic illness they may be carrying.”
And with nearly 10 percent of Pennsylvania newborns weighing less than 2,500 grams (5.5 pounds) – 12,108 children in 2009 according to state data – the issue isn’t a small one.
Researchers from Rainbow Babies and Children’s Hospital in Cleveland and elsewhere compared chronic illnesses in 181 children who weighed less than 2.2 pounds at birth at ages 8 and 14 with 115 normal weight babies of the same ages with similar “sociodemographic status.”
The researchers found that that overall the low birthweight babies had significantly higher rates of chronic illnesses at age 8 and 14 with two exceptions once both cohorts were teenagers. At age 14 the normal weight babies had similar rates of asthma as the low birthweight babies – 23 percent and 23 percent, respectively.
To most of us, however, the truly surprising finding was that both groups of children had similar rates of obesity – 19 percent for those born at extremely low birthweights versus 20 percent for the normal weight babies.
“The rates of chronic conditions were higher [for the low birthweight babies] but there were no significant differences in the rates of asthma or obesity” at 14 years of age, the researchers concluded.
“Obesity is yet another chronic condition on top of the already existing burden of chronic conditions these children face,” Dr. Hassink said. “We may have a window of opportunity here to just be aware of the risk as these children move from 8 to 14 into puberty and begin to address lifestyles that might prevent or ameliorate this problem.”