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Newborn CF screening programme fails to improve health inequalities

The introduction of the newborn bloodspot screening (NBS) programme for cystic fibrosis (CF) in 2007 appears to have delivered benefits in early measures of nutritional status and lung function but has had little effect on improving early health inequalities, according to a research published in Thorax.

The longitudinal study analysed UK CF registry data on over 3000 children with CF born between 2000 and 2015. Clinical outcomes were the trajectories of percentage predicted forced expiratory volume in one second (%FEV1) from age five years, weight for age and body mass index (BMI) standard deviation (SD) scores from age one year and time to chronic Pseudomonas aeruginosa (cPA) infection.

The data revealed that NBS was associated with higher average lung function trajectory (+1.56 [95% CI, 0.1-3.02] FEV1 percentage points; n=2216) and delayed onset of cPA. NBS was associated with higher average weight trajectory intercept at age one year (+0.16 [95% CI, 0.07-0.26] SD; n=3267) but negative rate of weight change thereafter (−0.02 [95% CI, −0.03 to −0.00] SD per year).

There was no significant association of NBS with BMI or rate of change of lung function, and there was no clear evidence of an effect of NBS on health inequalities early in life.

The authors say more research is needed to understand pathways to health inequalities for children with CF.

“In the meantime,” they say, “action to address poverty and improve social conditions for disadvantaged children growing up with CF is required to address health inequalities, even within the era of universal NBS.”


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