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Impact of cystic fibrosis on birthweight: a population based study of children in Denmark and Wales

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  • Daniela K Schlüter
  • Rowena Griffiths
  • Abdulfatah Adam
  • Ashley Akbari
  • Martin L Heaven
  • Shantini Paranjothy
  • Anne-Marie Nybo Andersen
  • Siobhán B Carr
  • Tania Pressler
  • Peter J Diggle
  • David Taylor-Robinson
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BACKGROUND: Poor growth during infancy and childhood is a characteristic feature of cystic fibrosis (CF). However, the impact of CF on intrauterine growth is unclear. We studied the effect of CF on birth weight in Denmark and Wales, and assessed whether any associations are due to differences in gestational age at birth.

METHODS: We conducted national registry linkage studies in two countries, using data for 2.2 million singletons born in Denmark (between 1980 and 2010) and Wales (between 1998 and 2015). We used hospital inpatient and outpatient data to identify 852 children with CF. Using causal mediation methods, we estimated the direct and indirect (via gestational age) effect of CF on birth weight after adjustment for sex, parity and socioeconomic background. We tested the robustness of our results by adjusting for additional factors such as maternal smoking during pregnancy in subpopulations where these data were available.

RESULTS: Babies with CF were more likely to be born preterm and with low birth weight than babies with no CF (12.7% vs 5% and 9.4% vs 5.8% preterm; 11.9% vs 4.2% and 11% vs 5.4% low birth weight in Denmark and Wales, respectively). Using causal mediation methods, the total effect of CF on birth weight was estimated to be -178.8 g (95% CI -225.43 to -134.47 g) in the Danish population and -210.08 g (95% CI -281.97 to -141.5 g) in the Welsh population. About 40% of this effect of CF on birth weight was mediated through gestational age.

CONCLUSIONS: CF significantly impacts on intrauterine growth and leads to lower birth weight in babies with CF, which is only partially explained by shorter gestation.

Original languageEnglish
JournalThorax
Volume74
Issue number5
Pages (from-to)447-454
ISSN0040-6376
DOIs
Publication statusPublished - May 2019

Bibliographical note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

    Research areas

  • clinical epidemiology, cystic fibrosis, Cystic Fibrosis/epidemiology, Follow-Up Studies, Humans, Male, Population Surveillance/methods, Gestational Age, Socioeconomic Factors, Incidence, Birth Weight, Denmark/epidemiology, Outpatients, Adult, Female, Registries, Retrospective Studies, Wales/epidemiology, Infant, Newborn

ID: 56390127