Body mass index increase in preschoolers with heterogeneous psychiatric diagnoses treated with risperidone

Objective: Use of risperidone in preschool-aged children is growing, with rising concerns of adverse metabolic consequences. Longitudinal data on risperidone-related weight gain in preschoolers are scarce. We aimed to evaluate changes in body mass index (BMI) that are associated with risperidone treatment in preschoolers. Method: We analyzed naturalistic, longitudinal data on 141 preschool children (112 boys, 29 girls) receiving psychiatric care. Mean patient age at baseline was 5.0 years (SD=0.8) and average follow-up period was 1.3 years (SD=0.8), with >8 mean BMI measurements per patient. We studied the effect of risperidone exposure ( n=78) on age-and-sex-standardized BMI (BMI Z-score) implementing mixed models with random subject intercepts to account for repeated measures, covarying for multiple confounders including demographics, stimulant treatment and psychiatric diagnoses. We employed similar models to study dose and duration effects. Results: Risperidone treatment was significantly associated with an increase in BMI (effect size of exposure=0.45 SD (SE=0.06), t (949)=7.7, p<0.001) covarying for stimulant exposure and other confounders, independent of treatment indication. Females exhibited stronger effects (risperidone treatment × sex interaction t=2.32, p=0.02)). Risperidone daily dose was associated with increase in BMI (for each additional 1 mg, effect size=0.28 SD (SE=0.07), t(419)=3.76, p<0.001). Conclusion: Similar to older populations, risperidone treatment in preschoolers is associated with significant weight gain, with evidence for dose effects. Findings provide critical data that can inform clinicians.

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622Low birthweight prediction is not improved by repeated measures of gestational weight: the BOSHI study

International Journal of Epidemiology ◽

10.1093/ije/dyab168.499 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Mari S Oba ◽

Yoshitaka Murakami ◽

Michihiro Sato ◽

Takahisa Murakami ◽

Noriyuki Iwama ◽

...

Keyword(s):

Body Mass Index ◽

Weight Gain ◽

Gestational Weight Gain ◽

Body Mass ◽

Repeated Measures ◽

Prediction Models ◽

Perinatal Outcomes ◽

Predictive Performance ◽

Repeated Measurements ◽

Gestational Weight

Abstract Background Both pre-pregnancy body mass index and total weight gain during pregnancy are known risk factors for perinatal outcomes. However, little is known if repeated measurements of gestational weight gain can be utilized in the prediction of perinatal outcomes. We examined whether repeated measures of gestational weight improve the prediction of low infant birthweight. Methods Using data from the BOSHI study, we developed prediction models with low infant birthweight (<2500 g) as the outcome and gestational weight gain as the exposure of interest. A prediction model (Model 1) using only baseline values (pre-pregnancy body mass index) as the exposure was compared with a model using baseline and the last weight measurement (Model 2) and a model using baseline and trimester-specific measurements (Model 3). Model performance was assessed using c-statistics, Brier scores, and calibration plots. Results Among women who experienced full-term deliveries and had measured weights, the proportion of low infant birthweights was 5%. The c-statistics of Model 1, Model 2, and Model 3 were 0.78, 0.81, and 0.83, respectively. Other assessments were relatively unchanged. The extent of predictive performance improvement depends not only on the exposure-outcome associations but correlations among exposure measurements. Conclusions The inclusion of repeated gestational weight measurements in a model for predicting low infant birthweight only produced a marginal improvement in predictive performance. Key messages The prediction of low infant birthweight is not substantially improved by using repeated measurements of gestational weight.

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