Newborn Screening for CF Linked to Better Pubertal Growth and Adult Height
People whose cystic fibrosis was detected through screening programs for newborns were found to have better growth throughout puberty and superior adult height, compared to those whose CF was diagnosed after they began exhibiting symptoms, researchers at the University of Wisconsin–Madison reported. The study, based on analyzed data from the Wisconsin Randomized Clinical Trial, “Pubertal Height Growth and Adult Height in Cystic Fibrosis After Newborn Screening,” was published in the journal Pediatrics.
To determine growth benefits of CF newborn screening (NBS) programs, researchers compared adolescent peak height velocity (PHV) and adult height in patients who had undergone NBS and a control group who did not. The study included data from 107 children born between 1985–1994, and followed through 2012.
Meconium ileus, a condition in a baby’s bowel that is highly associated with CF, was found in 25 patients, who also had the poorest pubertal growth and adult height. The 18 patients with pancreatic sufficiency achieved the best growth, with normal PHV and adult height. Among the 64 children with pancreatic insufficiency without meconium ileus, considered to be the patient subgroup most likely to benefit from NBS, screened children had similar PHV but better adult height when compared with controls. Among boys, those screened (22 patients) achieved normal PHV (9.5 cm) at 13.5 years of age, while unscreened controls (19 patients) had a 0.6 cm lower magnitude PHV at the same age. With girls, however, those in the screened group (10 patients) had later (12.5 years vs 11.7 years) and lower PHV (7.3 cm vs 7.9 cm) than the controls (13 patients).
Overall, adult height was also higher in the NBS screened group in comparison to the controls, a result that remained consistent after the analysis was adjusted for genetic potential. Researchers attributed these differences in adult height to benefits of NBS and to better prepubertal growth.
“The Wisconsin Randomized Clinical Trial project demonstrated that early diagnosis of cystic fibrosis within weeks of birth provides great opportunity to prevent detrimental nutrition and growth faltering in early infancy; in conjunction with appropriate nutritional therapy, such early growth benefits of newborn screening sustain long-term through puberty and lead to better adult height,” wrote the study’s lead author, Dr. Zhumin Zhang, with the department of nutritional sciences at Wisconsin, according to a news release.