肥満と減量療法のジャーナル

抽象的な

Using Process Control to Measure Pediatric Obesity

Lisaann S Gittner, Ludington-Hoe and Haller

Obesity beginning in infancy is a precursor to a life-long weight struggle and numerous co-morbidities. Thus, early diagnosis and intervention are of paramount importance. The study objectives were to use process control to produce control charts to determine and predict obesity from birth to 5-years of age. A descriptive comparative longitudinal study using retrospective chart review of height and weight at well-child visits from birth to five years of age was conducted in a Midwestern U.S. health maintenance organization. Participants were randomly selected children (n=223) of medically-uncomplicated gestations and pregnancies, and who had no medical complications other than non-food allergies. The children were classified as either normal weight, overweight or obese at five years of age using WHO reference standards. Control charts were developed to distinguish normal, overweight and obese growth patterns using longitudinal decision analysis. Decision limits were constructed for each time point; if a child is above decision limits, the child’s BMI is abnormally high with a p-value of >0.05, indicating significant difference compared to a normal value. From 2-12 months children categorized at 5-years as normal weight were slightly below the lower decision limit, overweight children were consistently between lower and upper decision limits, and obese children were above upper decision limit. Carefully constructed control charts are a powerful method to monitor growth processes. The charts have high obesity predictive ability when used with children over 2 months old; and should be considered as a method to monitor pediatric growth.