Pediatric BMI changes during COVID-19 pandemic: An electronic health record-based retrospective cohort study

Corinne G Brooks; Jessica R Spencer; J Michael Sprafka; Kimberly A Roehl; Junjie Ma; Ajit A Londhe; Fang He; Alvan Cheng; Carolyn A Brown; John Page

doi:10.1016/j.eclinm.2021.101026

Pediatric BMI changes during COVID-19 pandemic: An electronic health record-based retrospective cohort study

EClinicalMedicine. 2021 Jul 16:38:101026. doi: 10.1016/j.eclinm.2021.101026. eCollection 2021 Aug.

Authors

Corinne G Brooks¹, Jessica R Spencer^{1

2}, J Michael Sprafka^{1

3}, Kimberly A Roehl¹, Junjie Ma¹, Ajit A Londhe¹, Fang He¹, Alvan Cheng¹, Carolyn A Brown¹, John Page¹

Affiliations

¹ Center for Observational Research, Amgen, Inc., 1000 E Oaks Blvd, One Amgen Ctr. Dr. M/S 24-1-C, Thousand Oaks, California 91362, United States.
² SimulStat Inc, Solana Beach, 1000 E Oaks Blvd, One Amgen Ctr. Dr. M/S 24-1-C, Thousand Oaks, California 91362, United States.
³ Woodford Research Associates, 1000 E Oaks Blvd, One Amgen Ctr. Dr. M/S 24-1-C, Thousand Oaks, California 91362, United States.

Abstract

Background: Beginning March 2020, the COVID-19 pandemic has disrupted different aspects of life. The impact on children's rate of weight gain has not been analysed.

Methods: In this retrospective cohort study, we used United States (US) Electronic Health Record (EHR) data from Optum® to calculate the age- and sex- adjusted change in BMI (∆BMI_adj) in individual 6-to-17-year-old children between two well child checks (WCCs). The mean of individual ∆BMI_adj during 2017-2020 was calculated by month. For September-December WCCs, the mean of individual ∆BMI_adj (overall and by subgroup) was reported for 2020 and 2017-2019, and the impact of 2020 vs 2017-2019 was tested by multivariable linear regression.

Findings: The mean [95% Confidence Interval - CI] ∆BMI_adj in September-December of 2020 was 0·62 [0·59,0·64] kg/m², compared to 0·31 [0·29, 0·32] kg/m² in previous years. The increase was most prominent in children with pre-existing obesity (1·16 [1·07,1·24] kg/m² in 2020 versus 0·56 [0·52,0·61] kg/m² in previous years), Hispanic children (0·93 [0·84,1·02] kg/m² in 2020 versus 0·41 [0·36,0·46] kg/m² in previous years), and children who lack commercial insurance (0·88 [0·81,0·95] kg/m² in 2020 compared to 0·43 [0·39,0·47] kg/m² in previous years). ∆BMI_adj accelerated most in ages 8-12 and least in ages 15-17.

Interpretation: Children's rate of unhealthy weight gain increased notably during the COVID-19 pandemic across demographic groups, and most prominently in children already vulnerable to unhealthy weight gain. This data can inform policy decisions critical to child development and health as the pandemic continues to unfold.

Funding: Amgen, Inc.

Keywords: COVID-19; Obesity; Overweight; Pediatrics; Public health; Vulnerable populations.