Early attained weight and length predict growth faltering better than velocity measures in infants with CF
Sonya L Heltshe1, Drucy S Borowitz2, Daniel H Leung3
1Cystic Fibrosis Foundation Therapeutics Development Network, Seattle Children's Hospital Research Institute, Seattle, WA 98145, United States; University of Washington School of Medicine, Department of Pediatrics, Seattle, WA 98195, United States.
Insights
For infants with cystic fibrosis (CF), tracking attained growth (weight and length for age) is more effective than monitoring growth velocity for predicting future growth deficits. Early attained growth measurements better identify infants at risk for poor growth outcomes.
Area of Science:
- Pediatrics
- Growth Monitoring
- Cystic Fibrosis Research
Background:
- Infants with cystic fibrosis (CF) often experience growth deficiencies, impacting clinical outcomes.
- Early identification of growth deficits is crucial for timely intervention in CF patients.
Purpose of the Study:
- To compare attained growth for age versus velocity standards in predicting growth deficits at 24 months in infants with CF.
- To determine the most sensitive early indicators for growth deficiency in this population.
Main Methods:
- Analyzed growth data (weight and length velocity, attained growth) for 1992 infants from the US CF Foundation National Registry.
- Utilized World Health Organization (WHO) and US growth standards, calculating velocity over one, two, and three-month increments.
- Assessed sensitivity and specificity of early indicators to predict growth deficiency at 24 months of age.
Main Results:
- Attained weight for age showed a significantly higher prevalence of deficiency (26.8%) compared to velocity-based measures.
- Attained weight at four months demonstrated 100% sensitivity in predicting weight deficiency at 24 months, versus 40% for weight velocity.
- Attained length at four months was more sensitive (77%) in predicting stunting at 24 months than length velocity (30%).
Conclusions:
- In infants with cystic fibrosis, using attained weight or length measurements is more sensitive for predicting subsequent diminished growth than velocity-based definitions.
- Early assessment of attained growth provides a more reliable prediction of long-term growth deficits in CF infancy.
Background:
CF infants often do not grow as expected which adversely affects later clinical outcomes, thus sensitive early measures of growth deficiency are important. This study compared attained growth for age with velocity standards to determine which better predicts growth deficits at 24 months of age.
Methods:
Growth deficiency in infancy based on weight and length velocity, and attained growth was calculated for 1992 infants in the US CF Foundation National Registry using the World Health Organization (WHO) and US growth standards. One, two and three month increments were used for calculating velocity and pooled for each age interval. Sensitivity and specificity of early indicators to predict growth deficiency at 24 months were calculated.
Results:
Observed prevalence of weight deficiency (<10th percentile) during the first year of life was 26.8% higher (95% CI=(25.6, 28.1%), p<0.001) on average when measured by attained weight for age than velocity. Attained weight for age at four months was a more sensitive predictor of diminished weight for age (<10th percentile) at 24 months (sensitivity=100%, 95% CI=(87, 100%)) than weight velocity (sensitivity=40%, 95% CI=(23, 59%)). Attained length at four months was more sensitive to detecting subsequent stunting (<10th percentile length for age) (77%, 95% CI=(62, 87%)) than length velocity (30%, 95% CI=(19, 45%)).
Conclusions:
In CF infancy, attained weight or length is more sensitive than velocity-based definitions for predicting subsequent diminished growth.
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