Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Johns Hopkins Medical Institutions, Baltimore, MD, USA.
J Cyst Fibros. 2020 Nov;19(6):888-895. doi: 10.1016/j.jcf.2020.02.003. Epub 2020 Feb 12.
Prior literature shows that neonates with cystic fibrosis (CF) are more likely to be born low birth weight (LBW, <2500 grams) and/or small for gestational age (SGA, <10 percentile for weight) than non-CF counterparts. There is limited literature exploring the predictive effects of birth parameters on long-term outcomes.
The study population (CF Twin and Sibling Study) was recruited between 2000-2013 (n = 1677). Relationships between FEV percent predicted at 6, 12, or 18 years or BMI z-score at 2, 6, 12, or 18 years, and predictor variables (LBW or SGA status) were assessed using adjusted linear regressions.
Mean birth weight was 3.3 ± 0.7 kg (Females: 3.2 ± 0.7kg; males: 3.4 ± 0.7kg) and mean gestational age was 38.4 ± 2.6 weeks, with 10.2% of participants classified as SGA. Predictors of LBW included female sex, pancreatic insufficiency, and prematurity. Predictors of SGA included female sex. After adjustment, LBW was associated with lower BMI at ages 2-12 years and SGA was associated with lower BMI at age 2 years. LBW was associated with lower FEV percent predicted only at age 6 years. SGA was not associated with FEV.
We did not observe higher rates of LBW or SGA in full term infants compared to the general population. We observed associations particularly between LBW and BMI or FEV, but these associations decreased with age, suggesting that alternate factors contribute to outcomes over time. In lieu of the ability to target growth during gestation, efforts could be considered to optimize infant nutritional status, which may improve later life outcomes.
先前的文献表明，囊性纤维化（CF）新生儿比非 CF 新生儿更有可能出生时体重低（LBW，<2500 克）和/或小于胎龄（SGA，<10 百分位体重）。关于出生参数对长期结局的预测作用，文献有限。
研究人群（CF 双胞胎和兄弟姐妹研究）于 2000-2013 年期间招募（n=1677）。使用调整后的线性回归评估 FEV 预测值在 6、12 或 18 岁时的百分比或 BMI z 评分在 2、6、12 或 18 岁时与预测变量（LBW 或 SGA 状态）之间的关系。
平均出生体重为 3.3±0.7 公斤（女性：3.2±0.7kg；男性：3.4±0.7kg），平均胎龄为 38.4±2.6 周，有 10.2%的参与者被归类为 SGA。LBW 的预测因素包括女性、胰腺功能不全和早产。SGA 的预测因素包括女性。调整后，LBW 与 2-12 岁时的 BMI 较低相关，SGA 与 2 岁时的 BMI 较低相关。LBW 仅与 6 岁时的 FEV 预测百分比较低相关。SGA 与 FEV 无关。
我们没有观察到与一般人群相比，足月婴儿的 LBW 或 SGA 发生率更高。我们观察到 LBW 与 BMI 或 FEV 之间的关联，特别是 LBW 与 BMI 之间的关联，但这些关联随着年龄的增长而减少，这表明随着时间的推移，其他因素对结局有影响。由于无法在妊娠期间靶向生长，因此可以考虑努力优化婴儿的营养状况，这可能会改善以后的生活结局。
