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J Pediatr. 2019 Feb;205:202-209. doi: 10.1016/j.jpeds.2018.09.003. Epub 2018 Oct 9.

Relationship of Weight Outcomes, Co-Occurring Conditions, and Severity of Autism Spectrum Disorder in the Study to Explore Early Development.

Author information

1
Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, University of Pennsylvania, Philadelphia, PA.
2
Department of Biobehavioral Health Sciences, School of Nursing at University of Pennsylvania, Philadelphia, PA.
3
Department of Epidemiology, Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC.
4
Office of Nursing Research, School of Nursing at University of Pennsylvania, Philadelphia, PA.
5
Section of Nutrition/Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.
6
Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA.
7
Department of Epidemiology, Thomas Jefferson University, Philadelphia, PA.
8
Department of Pediatrics at the University of Colorado School of Medicine, Aurora, CO.
9
Waisman Center and the University of Wisconsin-Madison, Madison, WI.
10
National Center Birth Defects and Developmental Disability, Centers for Disease Control and Prevention, Atlanta, GA.

Abstract

OBJECTIVE:

To assess contributing factors to increased obesity risk, by comparing children with autism spectrum disorder (ASD), developmental delays/disorders, and general population controls in weight status, and to examine associations between weight status and presence of co-occurring medical, behavioral, developmental, or psychiatric conditions across groups and ASD severity among children with ASD.

STUDY DESIGN:

The Study to Explore Early Development is a multisite cross-sectional study of children, 2-5 years of age, classified as children with ASD (n = 668), children with developmental delays/disorders (n = 914), or general population controls (n = 884). Using an observational cohort design, we compared the 3 groups. Children's heights and weights were measured during a clinical visit. Co-occurring conditions (medical, behavioral, developmental/psychiatric) were derived from medical records, interviews, and questionnaires. ASD severity was measured by the Ohio State University Global Severity Scale for Autism.

RESULTS:

The odds of overweight/obesity were 1.57 times (95% CI 1.24-2.00) higher in children with ASD than general population controls and 1.38 times (95% CI 1.10-1.72) higher in children with developmental delays/disorders than general population controls. The aORs were elevated for children with ASD after controlling for child co-occurring conditions (ASD vs general population controls: aOR = 1.51; 95% CI 1.14-2.00). Among children with ASD, those with severe ASD symptoms were 1.7 times (95% CI 1.1-2.8) more likely to be classified as overweight/obese compared with children with mild ASD symptoms.

CONCLUSIONS:

Prevention of excess weight gain in children with ASD, especially those with severe symptoms, and in children with developmental delays/disorders represents an important target for intervention.

KEYWORDS:

autism; obesity

PMID:
30314662
PMCID:
PMC6348122
[Available on 2020-02-01]
DOI:
10.1016/j.jpeds.2018.09.003

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