Patterson, K, Kyriacou, T, Desai, M, Carroll, WD and Gilchrist, FJ FORTHCOMING: Predicting the growth of infants diagnosed with cystic fibrosis by newborn screening. American Journal of Paediatrics. (Unpublished)

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Abstract

Background: Newborn screening (NBS) for cystic fibrosis (CF) improves nutritional outcomes. Despite early dietetic
intervention some children fail to grow optimally. We report growth from birth to 2 years in a cohort of children
diagnosed with CF by NBS and identify the variables that influence future growth.
Methods: One hundred forty-four children were diagnosed with CF by the West Midlands Regional NBS laboratory
between November 2007 and October 2014. All anthropometric measurements and microbiology results from the
first 2 years were collated as was demographic and CF screening data. Classification modelling was used to identify
the key variables in determining future growth.
Results: Complete data were available on 129 children. 113 (88%) were pancreatic insufficient (PI) and 16 (12%)
pancreatic sufficient (PS). Mean birth weight (z score) was 3.17 kg (− 0.32). There was no significant difference in
birth weight (z score) between PI and PS babies: 3.15 kg (− 0.36) vs 3.28 kg (− 0.05); p = 0.33. By the first clinic visit
the difference was significant: 3.42 kg (− 1.39) vs 4.60 kg (− 0.48); p < 0.0001. Weight and height remained lower in PI
infants in the first year of life. In the first 2 years of life, 18 (14%) infants failed to regain their birth weight z score.
The median time to achieve a weight z score of − 2, − 1 and 0 was 18, 33 and 65 weeks respectively. The median
times to reach the same z scores for height were 30, 51 and 90 weeks. Birth weight z score, change in weight z
score from birth to first clinic, faecal elastase, isolation of Pseudomonas aeruginosa, isolation of Staphylococcus
aureus and sweat chloride were the variables identified by the classification models to predict weight and height in
the first and second year of life.
Conclusions: Babies with CF have a lower birth weight than the healthy population. For those diagnosed with CF
by NBS, the weight difference between PI and PS babies was not significantly different at birth but became so by
the first clinic visit. The presence of certain factors most already identifiable at the first clinic visit can be used to identify infant at increased risk of poor growth.

Item Type: Article
Divisions: Faculty of Natural Sciences > School of Computing and Mathematics
Depositing User: Symplectic
Date Deposited: 19 Aug 2020 10:09
Last Modified: 12 Mar 2021 11:20
URI: https://eprints.keele.ac.uk/id/eprint/8565

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