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How Do Early Weight Trajectories Explain Social Inequalities in Lung Function in Children With Cystic Fibrosis?: A

Daniela K Schlüter1, Ruth H Keogh2, Rhian M Daniel3

  • 1From the Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom.

Epidemiology (Cambridge, Mass.)
|January 6, 2025
PubMed

Insights

Socioeconomic deprivation negatively impacts lung function in children with cystic fibrosis (CF). Improving early growth in deprived children offers only a small reduction in these lung function inequalities.

Area of Science:

  • Pediatric Pulmonology
  • Health Disparities Research
  • Cystic Fibrosis (CF) Research

Background:

  • Children with CF from deprived areas exhibit poorer health outcomes, including growth and lung function.
  • Existing research links early growth to later lung function, but the impact of improving growth on reducing socioeconomic disparities in lung function remains unclear.

Purpose of the Study:

  • To investigate the association between socioeconomic deprivation and lung function in children with CF.
  • To determine the mediating role of early weight trajectories (ages 0-6) in the relationship between socioeconomic status and lung function at ages 6-8.

Main Methods:

  • Utilized data from the UK Cystic Fibrosis Registry (children born 2000-2010, tracked to 2016).
  • Employed an extended interventional disparity effects approach for longitudinally measured mediators.
  • Estimated associations between socioeconomic deprivation (least vs. most deprived quintiles) and lung function, adjusting for confounders like sex, birth year, genotype, and lung infections.

Main Results:

  • The study included 853 children; 165 from the least deprived and 172 from the most deprived quintiles.
  • A 4.5% lower predicted forced expiratory volume in 1 second (FEV1) was observed in the most deprived quintile compared to the least.
  • Matching early weight trajectories of the most deprived to the least deprived could reduce this lung function difference to 4%.

Conclusions:

  • Socioeconomic deprivation is strongly linked to reduced lung function in pediatric CF patients.
  • Interventions aimed at improving early weight trajectories in deprived children are estimated to only marginally decrease existing lung function inequalities.
Abstract

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