Fatores que afetam o crescimento e estado nutricional de pacientes com fibrose cística com idade inferior a 10 anos e que não foram submetidos à triagem neonatal

Abstract

OBJECTIVE: The aim of this study was to evaluate by clinical and laboratory parameters how cystic fibrosis (CF) affects growth and nutritional status of children who were undergoing CF treatment but did not receive newborn screening. METHODS: A historical cohort study of 52 CF patients younger than 10 years of age were followed in a reference center in Campinas, Southeast Brazil. Anthropometric measurements were abstracted from medical records until March/2010, when neonatal screening program was implemented. Between September/2009 and March/2010, parental height of the 52 CF patients were also measured. RESULTS: Regarding nutritional status, four patients had Z-scores ≤-2 for height/age (H/A) and body mass index/age (BMI/A). The following variables were associated with improved H/A ratio: fewer hospitalizations, longer time from first appointment to diagnosis, longer time from birth to diagnosis and later onset of respiratory disease. Forced vital capacity [FVC(%)], forced expiratory flow between 25-75% of FVC [FEF25-75(%)], forced expiratory volume in the first second [FEV1(%)], gestational age, birth weight and early respiratory symptoms were associated with improved BMI/A. CONCLUSIONS: Greater number of hospitalizations, diagnosis delay and early onset of respiratory disease had a negative impact on growth. Lower spirometric values, lower gestational age, lower birth weight, and early onset of respiratory symptoms had negative impact on nutritional status. Malnutrition was observed in 7.7% of cases, but 23% of children had nutritional risk.

Exames Para Avaliar a Sensibilização Ao Aspergillus Fumigatus Em Fibrose Cística

“…CF is a chronic disease that has seen remarkable progress in prognosis in recent years, besides increased survival rates, especially through early diagnoses using after-birth screening tests and with an improved control of the patients’ pulmonary disease and nutrition. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 …”

Associação entre pico de fluxo da tosse, colonização bacteriana e estado nutricional em crianças e adolescentes com fibrose cí­stica

“…Os resultados mostraram alta prevalência de risco nutricional na amostra (70,6%), o que é frequente nas crianças e adolescentes com FC [3][4][5]20,32,35]. Não houve diferença significativa entre os pacientes colonizados por Pseudomonas aeruginosa e Staphylococcus aureus, em relação às variáveis nutricionais, o que corrobora um estudo longitudinal recente, realizado no Brasil, que mostrou que o estado nutricional não foi fator de risco para infecção por P. aeruginosa [36].…”

“…O mau funcionamento do pâncreas exócrino causa comprometimento nutricional devido à má absorção e esteatorréia, comuns desde o nascimento. A desnutrição contribui para o déficit de crescimento [3] e está relacionada ao declínio da função pulmonar [3,4], e da qualidade de vida [5].…”

Nutrição em fibrose cística: tão importante quanto o manejo da doença pulmonar

“…However, the finding of a better H/A index with longer time between birth and diagnosis and between the first visit and diagnosis was paradoxical, as 90.8% of patients were pancreatic insufficient and in this situation, one would expect a worsening in this anthropometric index with diagnostic delay and thus, at the start of pancreatic enzyme supplementation. 9 …”

“…Entretanto, foi paradoxal o encontro de relação de melhor índice de A/I com maior tempo tanto entre o nascimento e o diagnóstico quanto entre a primeira consulta e o diagnóstico, uma vez que 90,8% dos pacientes eram pancreato-insuficientes e, nessa situação, esperar-se-ia uma pioria nesse índice antropométrico com o retardo no diagnóstico e, portanto, no início da suplementação das enzimas pancreáticas. 9 …”