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T H E   U S E   O F   A   P R E D I C T I O N   M O D E L   T O   P R E V E N T   A B N O R M A L  W E I G H T   I N   C H I L D H O O D   I N   T H E   Y O U T H   H E A L T H   C A R E   P R A C T I C E     Chapter  6   The   use   of   a   prediction   model   to   prevent   abnormal   weight   in   childhood   in   the   Youth  Health  Care  Practice   CHAPTER  6   The  use  of  a  prediction  model  to  prevent   abnormal  weight  in  childhood  in  the  Youth   Health  Care  Practice   Obesity  in  childhood  is  an  increasing  health  problem  and  once  it  has  been  established,  it  becomes   very  difficult  to  solve  this  problem.       Accordingly,  we  created  a  prediction  model  to  detect  the  tendency  of  becoming  overweight  in   childhood  at  a  moment  overweight  has  not  been  established  yet.       Data   for   this   study   were   retrospectively   collected   at   the   youth   health   care   department   of   the   Regional   Public   Health   Service   South   Limburg,   Maastricht.   Child   records   of   120   children,   born   in   2002,  who  developed  overweight  at  the  age  of  5  years,  were  collected.  As  a  control  group,  we  also   collected  data  of  120  children,  born  in  2002,  in  the  same  region,  who  did  not  develop  overweight  or   obesity  at  the  age  of  5  years.  Based  on  longitudinal  data,  the  expected  value  of  the  Ponderal  Index   (PIe)  at  a  certain  age  (t)  until  the  age  of  1  year,  depending  on  the  child’s  starting  position  at  birth   was  calculated.  According  to  our  hypothesis,  a  child  is  at  risk  for  overweight  at  the  age  of  5  years,  if   the  measured  PI  value  (PIm)  >  PIe  +  2SD.  We  applied  the  prediction  model  to  the  overweight  and  non   overweight  group  to  test  our  hypothesis.     We   compared   our   prediction   model   with   2   other   methods   to   estimate   (ab)normal   growth   of   children;       The  often  used  weight  for  length  growth  chart  and  The  PI  calculation.       Out  of  those  3  methods,  our  prediction  model  appears  to  be  the  best  predictor  for  overweight   at  the  age  of  5  years.     By  using  this  prediction  model,  we  are  able  to  estimate  the  growth  pattern  of  an  infant.  If  the   actual   growth   pattern   of   the   infant   does   not   fit   into   the   expected   growth,   intervention   may   be   needed  to  prevent  abnormal  growth.  By  implementing  the  prediction  model  in  the  electronic  child   record,   health   care   practitioners   could   use   this   model   in   preventing   overweight   in   children   at   an   early  age.       This  chapter  is  submitted  for  publication  by:   Manon   AB   Ernst,   Michelle   YG   Simons,   Maria   WJ   Jansen,   Luc   JI   Zimmermann   and   Willem  JM  Gerver.         89  


Proefschrift binnenwerk Manon Ernst_DEF.indd
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