51. Corrected 17-alpha-hydroxyprogesterone values adjusted by a scoring system for screening congenital adrenal hyperplasia in premature infants
- Author
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Ji Eun, Lee, Yeonsook, Moon, Moon Hee, Lee, Yong Hoon, Jun, Kyung Il, Oh, and Jong Weon, Choi
- Subjects
Treatment Outcome ,Adrenal Hyperplasia, Congenital ,Adrenocorticotropic Hormone ,Reference Values ,17-alpha-Hydroxyprogesterone ,Infant, Newborn ,Birth Weight ,Humans ,Gestational Age ,Infant, Premature, Diseases ,Infant, Premature - Abstract
This study investigated the use of corrected 17-alpha-hydroxyprogesterone (17-OHP) values to detect congenital adrenal hyperplasia (CAH) in newborn infants. 17-OHP concentrations in blood spots from 913 neonates were measured using a neonatal screening test. A prematurity index was calculated using a scoring system based on gestational age and birth weight. Blood spot 17-OHP concentrations divided by the sum of prematurity scores were defined as the corrected 17-OHP values. Preterm infants (30 wk) and low birth weight infants (1.0 kg) showed 3.9- and 3.8-fold higher blood spot 17-OHP concentrations than normal full term infants. However, no significant differences were observed in the corrected 17-OHP values between the groups. Blood spot 17-OHP levels yielded significant correlations with the prematurity index (r = 0.42, p0.05). Positive results for CAH were obtained in 9.5% (n = 53) and 2.0% (n = 11) of 556 premature infants by the cutoffs of blood spot 17-OHP (15.0 ng/ml) and corrected 17-OHP values (13.0 ng/ml), respectively. Of the 53 positive subjects, 39 (73.6%) converted to negative after 1 to 5 mo without treatment. In summary, blood spot 17-OHP levels are influenced by the prematurity of newborns. Use of corrected 17-OHP values provide limited but helpful information in screening for CAH by reducing the rate of false-positive results, especially in premature infants.
- Published
- 2008