324 A 10-year review of infant growth outcomes in a cystic fibrosis centre

Objectives Cystic fibrosis (CF) is an inherited, life-shortening multi-systemic disease.1Patients present predominantly through the UK screening program, but a smaller population initially present as meconium ileus (MI).1 Growth outcomes in infancy, specifically growth achieved at 1 year is an important marker for later lung function and other health markers.2 The primary outcomes were to evaluate the prevalence of re-achieving birth centile by age 1 and the incidence of growth failure (defined by NICE guidelines) of infants managed in a single UK CF Centre. The secondary outcomes were to investigate the growth patterns and outcomes in the two presentation groups (screening vs MI) and in those exclusively breastfed. Methods Data was extracted from a dedicated CF database and medical notes for growth charts and additional clinical information. CF patients born between 2011 and 2021 were selected for inclusion. Anthropometric measurements (centiles, Z-scores) and methods of feeding were recorded three-monthly during the first year of life, and when available at 24 months. Results were then tabulated and statistics were run using SPSS (version 28.0.1.1 15). Results 23 patients were identified. Overall, 73% of patients re-achieved birth centiles at 1 year. There was a prevalence of 39% growth failure. 62.5% of all patients with growth failure re-achieved their birth centiles at 1 year. 15 patients presented through screening, 8 presented with MI. 67% of those with growth failure were MI. Patients presenting with MI were born heavier (Z-score-weight=-0.02±0.66) and longer (Z-score-lenght=2.51±1.31) than patients presenting through screening (Z-score-weight=-0.5±1.05; Z-score-length=1.13±1.43). All patients Z-score-weight declined by 3 months but the decline for MI patients was sharper as seen in figure 1. By 12 months, there was no statistically significant difference in the mean Z-score for weight between the MI (0.40±0.59) and the screening group (0.37±0.80). At birth, 65% of patients were exclusively breast-fed (exBF). At 3 months, that prevalence decreased to 30%, further decreasing to 17% at 12 months. There was a significant difference of -0.31 (95% CI [-0.66; -0.51]) in Z-score-weight between those exBF for 12 months (- 0.51 ± 0.56) compared to all other feeding methods (mixed feeding, exclusive formula etc) (-0.20 ± 0.94); t(27)=-1.76,p=0.045 (Graph 2). Conclusions Despite regular monitoring and intervention, growth failure was still observed in this cohort. CF patients remain high risk for sub-optimal growth, specifically MI patients. Whilst breastfeeding is internationally recommended, this data highlights the extra care required to support growth. References UK Cystic Fibrosis Registry Annual Data Report 2019, Cystic Fibrosis Trust, 2020 August Trajectories of early growth and subsequent lung function in cystic fibrosis: an observational study using UK and Canadian registry data, Macdougall et al., 2022 September

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