391 - Large for Gestational Age Infants and Body Mass Index at Age Five Years in a Multiethnic Community Hospital.

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 391
Publication Number: 391.145

Ariela Valdez Holguin, Flushing Hospital Medical Center, Flushing, NY, United States; Neelam Neupane, Flushing hospital medical center, corona, NY, United States; Lochana KC, Flushing hospital medical center, Flushing, NY, United States; Shirley Pinero-Bernardo, Flushing Hospital Medical Center, Flushing, NY, United States; Ashley Hiza, Flushing, Hospital medical center, Flushing, NY, United States; Lily Q. Lew, Flushing Hospital Medical Center, Flushing, NY, United States; Gigliola Dolmaian, Flushing hospital medical center, Flushing, NY, United States

Presenting Author(s)

Ariela Valdez Holguin, MD (she/her/hers)

Pediatric resident
Flushing Hospital Medical Center
Flushing, New York, United States

Background: Large for gestational age (LGA) describes a newborn weighing >90^th percentile for gestational age (GA) and gender or a birth weight (BW) more than 4000 grams. Maternal factors including uncontrolled diabetes mellitus, obesity and excessive weight gain are known to cause large newborns. Studies have shown increased risk for overweight/obesity when born LGA. Adipose rebound is the second rise in body mass index (BMI) seen between ages 5-7 years. A risk factor for later obesity includes early adipose rebound. There are limited studies on LGA infants and BMI at age 5-years in a multiethnic community hospital.

Objective: To explore BMI at age 5-years of children born LGA.

Design/Methods:

A retrospective chart review of term infants born LGA at Flushing Hospital Medical Center between January 2014 and December 2017. Data extracted from the EHR included demographics, maternal BMI and medical history, GA, mode of delivery, gender, BW, feeding type (breast, formula, mixed), and 5-year BMI. The 5-year BMI was grouped according to percentile: underweight (< 5^th percentile), normal (5^th-< 85^th percentiles), overweight (>85^th-< 95^th percentiles) and obese (>95^th percentile). Data were analyzed using SPSS and percentages, p-value of < 0.05 was considered significant.

Results:

Of 81 neonates born LGA at term, 46 (57%) were male. The predominant ethnicities were Hispanic (77%), Asian (17%) and African-American (4%). The mean BW was 4110.5+213.4 grams. Maternal BMI >30 kg/m²was in more than half (57%) and gestational diabetes mellitus in less than a fifth (16%). Most children at age 5-years had a normal BMI (46%) followed by obese BMI (32%), overweight BMI (17%) and underweight (5%). There were no significant differences in maternal BMI>30 kg/m² (underweight 4%, normal 22%, overweight 9%, obese 22%, p=0.17) and gestational diabetes mellitus (underweight 0%, normal 6%, overweight 4%, obese 6%, p=0.70) when comparing the four 5-year BMI groups. Higher maternal BMI was associated with greater risk of delivering by cesarean section, p=0.03. Almost three quarters of the LGA neonates (74%) were fed both breast milk and formula, and exclusively breast milk in a quarter (24%), p=0.52.

Conclusion(s): In our small sample, LGA and higher maternal BMI were not risk factors for BMI>95^th percentile at age 5-years. Mixed feeding was the most common feeding type for all 5-year BMI groups. Higher maternal BMI was more likely to deliver by cesarean section.