Differences between WHO AND CDC early growth measurements in the assessment of Cystic Fibrosis clinical outcomes

J Cyst Fibros. 2017 Jul;16(4):503-509. doi: 10.1016/j.jcf.2016.12.001. Epub 2016 Dec 15.


Background: Early childhood growth status has been used to predict long-term clinical outcomes in Cystic Fibrosis (CF) patients. Adulthood CF outcomes based on early weight-for-length (WFL) measurements, using either World Health Organization (WHO) or Centers for Disease Control (CDC) scales, have not been compared.

Methods: Cystic Fibrosis Foundation registry patients were studied (n=3014). Participants were categorized at age two years as WFL <50th percentile on both WHO and CDC scales, ≥50th percentile on WHO but not CDC, or ≥50th percentile on both. Pulmonary function and overall survival were assessed at age 18years.

Results: Stepwise gains in pulmonary function and lung transplant-free survival were noted across the three increasing WFL categories.

Conclusions: Children with CF who achieve higher WFL at age two years have improved pulmonary and survival outcomes into adulthood. CF providers should continue to utilize current early growth recommendations, with goal WFL ≥50th percentile on CDC growth charts before age two.

Keywords: Cystic Fibrosis (CF); Forced Expiratory Volume in 1second percent predicted (FEV1(pp)); Growth standards; Survival; Weight-for-length (WFL).

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Anthropometry / methods*
  • Body Height*
  • Centers for Disease Control and Prevention, U.S.
  • Child Development
  • Child, Preschool
  • Cystic Fibrosis* / diagnosis
  • Cystic Fibrosis* / physiopathology
  • Female
  • Growth*
  • Humans
  • Male
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / standards
  • Registries / statistics & numerical data
  • Respiratory Function Tests / methods
  • Respiratory Function Tests / statistics & numerical data
  • Survival Analysis
  • United States / epidemiology
  • World Health Organization