Benefits of Paediatric to Adult Transition Programme in Inflammatory Bowel Disease: The BUTTERFLY Study of GETECCU and SEGHNP.

(1) Background: Transition is a planned movement of paediatric patients to adult healthcare systems, and its implementation is not yet established in all inflammatory bowel disease (IBD) units. The aim of the study was to evaluate the impact of transition on IBD outcomes. (2) Methods: Multicentre, retrospective and observational study of IBD paediatric patients transferred to an adult IBD unit between 2017-2020. Two groups were compared: transition (≥1 joint visit involving the gastroenterologist, the paediatrician, a programme coordinator, the parents and the patient) and no-transition. Outcomes within one year after transfer were analysed. The main variable was poor clinical outcome (IBD flare, hospitalisation, surgery or any change in the treatment because of a flare). Predictive factors of poor clinical outcome were identified with multivariable analysis. (3) Results: A total of 278 patients from 34 Spanish hospitals were included. One hundred eighty-five patients (67%) from twenty-two hospitals (65%) performed a structured transition. Eighty-nine patients had poor clinical outcome at one year after transfer: 27% in the transition and 43% in the no-transition group (p = 0.005). One year after transfer, no-transition patients were more likely to have a flare (36% vs. 22%; p = 0.018) and reported more hospitalisations (10% vs. 3%; p = 0.025). The lack of transition, as well as parameters at transfer, including IBD activity, body mass index < 18.5 and corticosteroid treatment, were associated with poor clinical outcome. One patient in the transition group (0.4%) was lost to follow-up. (4) Conclusion: Transition care programmes improve patients' outcomes after the transfer from paediatric to adult IBD units. Active IBD at transfer impairs outcomes.

Early life risk factors and their cumulative effects as predictors of overweight in Spanish children.

OBJECTIVES: To explore early life risk factors of overweight/obesity at age 6 years and their cumulative effects on overweight/obesity at ages 2, 4 and 6 years. METHODS: Altogether 1031 Spanish children were evaluated at birth and during a 6-year follow-up. Early life risk factors included: parental overweight/obesity, parental origin/ethnicity, maternal smoking during pregnancy, gestational weight gain, gestational age, birth weight, caesarean section, breastfeeding practices and rapid infant weight gain collected via hospital records. Cumulative effects were assessed by adding up those early risk factors that significantly increased the risk of overweight/obesity. We conducted binary logistic regression models. RESULTS: Rapid infant weight gain (OR 2.29, 99% CI 1.54-3.42), maternal overweight/obesity (OR 1.93, 99% CI 1.27-2.92), paternal overweight/obesity (OR 2.17, 99% CI 1.44-3.28), Latin American/Roma origin (OR 3.20, 99% CI 1.60-6.39) and smoking during pregnancy (OR 1.61, 99% CI 1.01-2.59) remained significant after adjusting for confounders. A higher number of early life risk factors accumulated was associated with overweight/obesity at age 6 years but not at age 2 and 4 years. CONCLUSIONS: Rapid infant weight gain, parental overweight/obesity, maternal smoking and origin/ethnicity predict childhood overweight/obesity and present cumulative effects. Monitoring children with rapid weight gain and supporting a healthy parental weight are important for childhood obesity prevention.

Infant growth and early adiposity depending on immigrant background and anthropometric standards; the CALINA Study.

OBJECTIVE: To compare infant growth and adiposity pattern up to 2 years of age in Spanish infants, depending on maternal origin and anthropometric standards. METHODS: Longitudinal study of a representative cohort of infants born at term in Aragon (Spain) (n = 1.430). Mean z-scores of weight, length, body mass index, triceps and subscapular skinfolds were calculated until 24 months of age using World Health Organization (WHO), Euro-Growth and Spanish growth standards and categorized by maternal origin (Spanish vs. immigrant). RESULTS: Infants of immigrant mothers had higher weight, length, body mass index, triceps and subscapular skinfolds than Spanish maternal origin infants during the first months of life. Mean z-scores significantly varied depending on growth standards used. At 18 months of age, all anthropometric differences between both groups disappeared, but only when using WHO growth standards. Mean triceps and subscapular skinfold z-scores substantially and progressively increased from 3 months to 24 months of age in both groups compared to WHO standards. At 24 months, the prevalence of infants at risk of overweight and overweight were similar in both groups (Spanish: 15.1% and 3.8%; immigrant: 14.7% and 4.9%, respectively). CONCLUSIONS: Infant growth, adiposity patterns and prevalence of overweight depend on maternal origin, showing initial differences which progressively disappeared at 24 months of life when WHO growth standards were used. Differences in infant mean anthropometric measurements depend on anthropometric standard used.

Infant growth and early adiposity depending on immigrant background and anthropometric standards; the CALINA Study / Crecimiento y adiposidad durante la primera infancia dependiendo del origen de la familia y de los estándares antropométricos; estudio CALINA

Objective: To compare infant growth and adiposity pattern up to 2 years of age in Spanish infants, depending on maternal origin and anthropometric standards. Methods: Longitudinal study of a representative cohort of infants born at term in Aragon (Spain) (n = 1.430). Mean z-scores of weight, length, body mass index, triceps and subscapular skinfolds were calculated until 24 months of age using World Health Organization (WHO), Euro-Growth and Spanish growth standards and categorized by maternal origin (Spanish vs. immigrant). Results: Infants of immigrant mothers had higher weight, length, body mass index, triceps and subscapular skinfolds than Spanish maternal origin infants during the first months of life. Mean z-scores significantly varied depending on growth standards used. At 18 months of age, all anthropometric differences between both groups disappeared, but only when using WHO growth standards. Mean triceps and subscapular skinfold z-scores substantially and progressively increased from 3 months to 24 months of age in both groups compared to WHO standards. At 24 months, the prevalence of infants at risk of overweight and overweight were similar in both groups (Spanish: 15.1% and 3.8%; immigrant: 14.7% and 4.9%, respectively). Conclusions: Infant growth, adiposity patterns and prevalence of overweight depend on maternal origin, showing initial differences which progressively disappeared at 24 months of life when WHO growth standards were used. Differences in infant mean anthropometric measurements depend on anthropometric standard used (AU)

Objetivo: comparar el patrón de crecimiento infantil y adiposidad temprana hasta los 2 años en los niños españoles, según el origen materno y los estándares antropométricos. Métodos: estudio longitudinal en una cohorte representativa de niños nacidos a término en Aragón (España) (n = 1.430). Se calcularon z-scores de peso, longitud, índice de masa corporal, pliegue tricipital y subescapular hasta los 2 años usando estándares de crecimiento de la Organización Mundial de la Salud (OMS), Euro-Growth y nacionales, y se categorizaron según el origen materno (español vs. inmigrante). Resultados: los niños de madre de origen inmigrante presentaron mayor peso, longitud, índice de masa corporal y pliegues tricipital y subescapular que los de origen español durante los primeros meses de vida. Los valores medios de z-score variaron significativamente según el estándar de crecimiento utilizado. A los 18 meses, las diferencias entre ambos grupos desaparecieron solo al emplear los estándares de la OMS. Los valores de z-score de pliegues tricipital y subescapular se incrementaron de manera sustancial y progresiva desde los 3 a los 24 meses comparándolos con los estándares de la OMS. A los 24 meses, la prevalencia de niños con riesgo de sobrepeso y sobrepeso fue similar en ambos grupos (español: 15,1% y 3,8%; inmigrante: 14,7% y 4,9%, respectivamente). Conclusiones: el patrón de crecimiento y la adiposidad durante la primera infancia, así como la prevalencia de sobrepeso mostraron diferencias según el origen de la madre que desaparecieron progresivamente a los 24 meses de vida al emplear los estándares de la OMS. Se objetivaron diferencias en los valores antropométricos según el estándar de crecimiento utilizado (AU)