357 MECONIUM SCREENING FOR CYSTIC FIBROSIS

Abstract

Meconium Screening for CF based on increased albumin content in the meconium of CF newborns is used in Europe for early detection. A recent collaborative study in U.S. centres did not find BMC-test meconium screening, done at the bedside as currently marketed, wholly satisfactory. We wish to report results of a 2 year “centralized lab” study involving 30,000 infants born up to 400 miles distant from the laboratory in 20 rural and urban hospitals. The project was managed by a nurse who visited each hospital, gave instructions on collection, freezing and shipment of meconium samples. A central lab tested all samples first with BMC strips. All BMC positive samples with an adequate quantity of meconium had albumin quantitated by radial immunodiffusion (RID) technique. Sweat chlorides were requested on all babies with > 10 mgm albumin/gm wet weight meconium and on those 30 whose BMC was positive but meconium insufficient for quantitation. Results to 10/30/1977: Infants tested 30,851. Samples lost or not collected = 251 (0.81%). BMC pos (+) = 124 (0.4%). BMC +, RID + or RID nsq = 85 (0.27%), study pos group, BMC +, RID + = 49/94, BMC +, RID - = 45. Sweats incomplete = 7. Infants “study + “, sweat += 7. Infant “study -” sweat + = 1. Meconium collected 48 hrs post op from meconium ileus pt. nsq for test was sweat +. We conclude that BMC-test meconium performed in a central lab with albumin quantitation for positive strips is a suitable CF screen for both urban and rural populations, acceptably specific and selective, and can be done at reasonable cost.