Pulmonary outcome differences in U.S. and French cystic fibrosis cohorts diagnosed through newborn screening

J Cyst Fibros. 2010 Jan;9(1):44-50. doi: 10.1016/j.jcf.2009.10.004. Epub 2009 Nov 18.

Abstract

Background: A comparison of the longitudinal progression of lung disease in cystic fibrosis patients identified through newborn screening (NBS) in cohorts located in two different countries has never been performed and was the primary objective of this study.

Methods: The study included 56 patients in Brittany diagnosed through NBS between 1989 and 1994 and 69 similar patients in Wisconsin between 1985 and 1994. The onset and progression of lung disease was radiographically quantified using the Wisconsin Chest X-ray (WCXR) scoring system. A single pediatric pulmonologist blinded to all identifiers scored the films.

Results: Generalized estimating equation analyses adjusted for age, genotype, sex, pancreatic insufficiency, and meconium ileus showed worse WCXR scores in Brittany patients compared to Wisconsin patients (average score difference=4.48; p<0.001). Percent predicted FEV1 was also worse among Brittany patients (p<0.001).

Conclusions: The finding of milder radiographically-quantified lung disease using the WCXR scoring system, as well as better FEV1 values, may be explained by variations in nutrition, environmental exposures, or healthcare delivery.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bronchiectasis / diagnostic imaging
  • Bronchiectasis / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cystic Fibrosis / diagnostic imaging*
  • Cystic Fibrosis / epidemiology*
  • Female
  • Forced Expiratory Volume
  • France / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Lung / diagnostic imaging*
  • Male
  • Mass Chest X-Ray
  • Neonatal Screening*
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology
  • Wisconsin / epidemiology