Pulmonary outcome differences in U.S. and French cystic fibrosis cohorts diagnosed through newborn screening.
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.
Walsh
Aimee C
AC
School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
Rault
Gilles
G
Li
Zhanhai
Z
Scotet
Virginie
V
Duguépéroux
Ingrid
I
Férec
Claude
C
Roussey
Michel
M
Laxova
Anita
A
Farrell
Philip M
PM
D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D005541:Forced Expiratory Volume; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008400:Mass Chest X-Ray; D015997:Neonatal Screening; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014922:Wisconsin / Q000453:epidemiology