Severe obesity and global developmental delay in preschool children: Findings from a Canadian Paediatric Surveillance Program study

Nicole D Gehring¹, Catherine S Birken², Stacey Belanger³, Tracey Bridger⁴, Jean-Pierre Chanoine⁵, William T Gibson⁶, Stasia Hadjiyannakis⁷, Jess Haines⁸, Jill Hamilton⁹, Andrea M Haqq¹⁰, Mélanie Henderson³, Josephine Ho¹¹, Brittany Irvine¹², Laurent Legault¹³, Paola Luca¹¹, Jonathon Maguire², Amy C McPherson^{14

15}, Katherine Morrison¹⁶, Gita Wahi¹⁶, Rosanna Weksberg¹⁴, Lonnie Zwaigenbaum¹⁰, Geoff D C Ball¹⁰

Affiliations

¹ School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
² Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
³ Department of Pediatrics, University of Montreal, Montreal, Québec, Canada.
⁴ Discipline of Pediatrics, Memorial University, St. John's, Newfoundland and Labrador, Canada.
⁵ Division of Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada.
⁶ Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
⁸ Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
⁹ Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
¹¹ Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
¹² Public Health Agency of Canada, Ottawa, Ontario, Canada.
¹³ Department of Pediatrics, McGill University, Montreal, Québec, Canada.
¹⁴ Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada.
¹⁵ Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
¹⁶ Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

PMID: 37151929
PMCID: PMC10156927
DOI: 10.1093/pch/pxac109

Severe obesity and global developmental delay in preschool children: Findings from a Canadian Paediatric Surveillance Program study

Nicole D Gehring et al. Paediatr Child Health. 2022.

. 2022 Nov 12;28(2):107-112.

doi: 10.1093/pch/pxac109. eCollection 2023 May.

Authors

Affiliations

¹ School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
² Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
³ Department of Pediatrics, University of Montreal, Montreal, Québec, Canada.
⁴ Discipline of Pediatrics, Memorial University, St. John's, Newfoundland and Labrador, Canada.
⁵ Division of Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada.
⁶ Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.
⁷ Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.
⁸ Department of Family Relations & Applied Nutrition, University of Guelph, Guelph, Ontario, Canada.
⁹ Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
¹¹ Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
¹² Public Health Agency of Canada, Ottawa, Ontario, Canada.
¹³ Department of Pediatrics, McGill University, Montreal, Québec, Canada.
¹⁴ Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Ontario, Canada.
¹⁵ Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.
¹⁶ Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

PMID: 37151929
PMCID: PMC10156927
DOI: 10.1093/pch/pxac109

Abstract

Background: The co-presentation of severe obesity (SO) and global developmental delay (GDD) in Canadian preschool children has not been examined. However, SO and GDD may require syndromic diagnoses and unique management considerations.

Objectives: To determine (1) minimum incidence; (2) age of onset and risk factors; and (3) health care utilization for co-presenting SO and GDD.

Methods: Through the Canadian Paediatric Surveillance Program (CPSP), a monthly form was distributed to participants from February 2018 to January 2020 asking for reports of new cases of SO and GDD among children ≤5 years of age. We performed descriptive statistics for quantitative questions and qualitative content analysis for open-ended questions.

Results: Forty-seven cases (64% male; 51% white; mean age: 3.5 ± 1.2 years) were included. Age of first weight concern was 2.5 ± 1.3 years and age of GDD diagnosis was 2.7 ± 1.4 years. Minimum incidence of SO and GDD was 3.3 cases per 100,000 for ≤5 years of age per year. Identified problems included school and/or behavioural problems (n = 17; 36%), snoring (n = 14; 30%), and asthma/recurrent wheeze (n = 10; 21%). Mothers of 32% of cases (n = 15) had obesity and 21% of cases (n = 10) received neonatal intensive care. Microarray was ordered for 57% (n = 27) of children. A variety of clinicians and services were accessed. As reported by CPSP participants, challenges faced by families and health service access were barriers to care.

Conclusion: Children with SO and GDD have multiple comorbidities, and require early identification and referral to appropriate services. These cases may also benefit from additional testing to rule out known genetic obesity syndromes.

Keywords: Canadian Paediatric Surveillance Program; Global developmental delay; Preschool children; Severe obesity.

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Conflict of interest statement

WTG received research funding from the Canadian Institutes of Health Reearch. AMH is a member of the Clinical Advisory Board, Setmelanotide for BBS/Alstrom’s disease, Rhythm Pharmaceuticals; Chair, Scientific Advisory Board, PWS USA and PI for clinical trials with Rhythm pharmaceuticals and Levo Therapeutics. KMM has served as a member of an advisory board for Novo Nordisk and is on a Data Safety Monitoring committee for Novartis. She has received research funding from the Canadian Institutes of Health Research and McMaster University. JH has consulted for Novo Nordisk and the Pediatric Obesity National Advisory Board. She has received funding from Mead Johnson, Levo Therapeutics, and the Foundation for Prader-Willi Research. MH holds a Fonds de la recherche du Québec – Santé (FRQS) Junior 2 Clinical Research Scholar Award and is the recipient of the 2019 Canadian Society for Endocrinology and Metabolism Young Investigator Award. She is member of Canada’s Children’s Hospitals Foundation (CCHF) and Sun Life Child and Youth Type 2 Diabetes Prevention Initiative. She has received research funding from the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada, Diabète Québec, the Fonds de Recherche du Québec – Santé, the Quebec Cardiometabolic Health, Diabetes and Obesity Network and the Quebec Network on Nursing Intervention Research, as well as through the Canada’s Children’s Hospitals Foundation (CCHF)/Sun Life initiative. GDCB served as a member of a national advisory board with Novo Nordisk Canada. He received research funding from the Canadian Institutes of Health Research, Public Health Agency of Canada, Alberta Health Services, Alberta Innovates, and the Women and Children’s Health Research Institute (UAlberta). All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

**Figure 1.**
Flow chart of cases. *BMI Body mass index; CPSP Canadian Paediatric Surveillance Program; GDD global developmental delay*.

See this image and copyright information in PMC

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Severe obesity and global developmental delay in preschool children: Findings from a Canadian Paediatric Surveillance Program study

Affiliations

Severe obesity and global developmental delay in preschool children: Findings from a Canadian Paediatric Surveillance Program study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

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