Newborns screened cystic fibrosis in Britanny versus unscreened in Loire-Atlantique: a comparative study since 1989

Neonatal screening for cystic fibrosis was started in Brittany in 1989 but not in the adjacent department of Loire-Atlantique. This study compares the outcome from the children of both populations nine years after the beginin g of the screening. Those children were seen in different centers but with the same following guidelines. Population and methods. - All children with cystic fibrosis born between 01 /01/89 and 31/12/97 in Brittany and the Loire-Atlantique, excluding the mec onium ileus, were compared for their initial characteristics and their outc ome after nine years of follow-up. Results. - There was no significant difference betweeen both populations fo r sex ratio, gestational age, birth biometry, percentage of homozygotes Del ta F503, and mean age of children. Age at diagnosis was lower in Brittany ( 37 vs 372 days, P < 10(-7)), as was the delay for starting pancreatic suppl ementation (1.5 vs 14.3 months, P < 10(-7)). Percentage of children hospita lized at least once was higher in Loire-Atlantique (84.4 vs 40.3%, P < 10(- 4)). TL,ere was no significant difference for colonization with Pseudomonas aeruginosa. Z-scores for weight and height were better in Brittany, as wer e Shwachman's and Brasfield's scores. Conclusion. - The homogeneity of both populations and their follow-up point s out that even if the numbers of children are small and the study is retro spective, some benefits of neonatal screening appear, which are already fou nd in other countries where it is partly practiced. This leads us recommend its general use in our populations, which should be associated with the fo llow-up of the screened children in cystic fibrosis centers to achieve the most of its benefits. (C) 2000 Editions scientifiques et medicales Elsevier SAS.