Neonatal Ampicillin/Gentamicin Exposure and the Risk of Childhood Obesity in South Bronx Pediatric Population.

OBJECTIVE: This study aimed to assess the association between neonatal antibiotic exposure and the risk of childhood obesity. STUDY DESIGN: This retrospective cohort study enrolled neonates born between 2011 and 2015 and followed up until 5 years. The incidence of obesity at 5 years old, and other characteristics were compared between the antibiotic-exposed and unexposed groups. Chi-square test was conducted on categorical variables and Student's t-test for normally distributed continuous variable. Significant variables (p < 0.05) in bivariate analysis were modelled in a stepwise multivariate logistic regression analysis to ascertain independent predictors of obesity at 5 years. RESULTS: Of the 1,447 subjects, 749 (51.8%) received ampicillin and gentamicin, and 333 (23%) were obese. Neonates exposed to antibiotics were more likely to be obese compared with those unexposed (26 vs. 20%, p = 0.01). In the adjusted model, this association persisted (adjusted odds ratio: 1.37, p = 0.02). CONCLUSION: Neonatal antibiotic exposure is associated with early childhood obesity and may play a significant role in the weight trajectories of these children. Hence, antibiotic stewardship in this period cannot be overemphasized. KEY POINTS: · Findings from our study showed that neonatal antibiotic exposure is associated with early childhood obesity.. · The prevalence of childhood obesity at 5 years is high (23%).. · Further exploration of the role of antibiotics on the gut microbiome and its effect on weight trajectories is needed..

Exploring the mind-body connection from puberty to the interSEXtion of eating disorders and reproductive health: What mental health providers should know.

Eating disorders have potential to significantly impact growth and sexual development, particularly when associated with malnutrition. The hypothalamic-pituitary-gonadal axis, which dictates puberty and sexual maturation, including bone growth, is sensitive to metabolic changes such as those in eating disorders. Consequences may include pubertal delay/arrest, stunted growth, weakened bones, menstrual changes, impotence, sexual dysfunction, infertility, or adverse pregnancy outcomes. The physical and psychological impacts of eating disorders can also affect intimate relationships and sexual satisfaction. Visits to mental health providers offer an opportunity to assess the development and reproductive health concerns of patients with eating disorders. The purpose of this article is to review the epidemiology, pathophysiology, and morbidities of the reproductive sequelae of eating disorders and to educate mental health providers on when to refer patients for further medical evaluation.

Hypogonadotropic Hypogonadism and Kleefstra Syndrome due to a Pathogenic Variant in the EHMT1 Gene: An Underrecognized Association.

Kleefstra syndrome is a genetic condition characterized by intellectual disability, childhood hypotonia, and facial dysmorphisms. Genital anomalies such as micropenis, cryptorchidism, and hypospadias have been reported in 30-40% of males diagnosed with the disease. However, endocrinological investigations have been limited. We describe a case of an adolescent male with Kleefstra syndrome due to a pathogenic variant in the EHMT1 gene whose workup for isolated micropenis is suggestive of a partial hypogonadotropic hypogonadism. A possible endocrine mechanism of the genital anomaly associated with Kleefstra syndrome is discussed.