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Corrected 17-alpha-hydroxyprogesterone values adjusted by a scoring system for screening congenital adrenal hyperplasia in premature infants.

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, p <0.05). 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.
AuthorsJi Eun Lee, Yeonsook Moon, Moon Hee Lee, Yong Hoon Jun, Kyung Il Oh, Jong Weon Choi
JournalAnnals of clinical and laboratory science (Ann Clin Lab Sci) Vol. 38 Issue 3 Pg. 235-40 ( 2008) ISSN: 1550-8080 [Electronic] United States
PMID18715851 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • 17-alpha-Hydroxyprogesterone
  • Adrenocorticotropic Hormone
Topics
  • 17-alpha-Hydroxyprogesterone (blood)
  • Adrenal Hyperplasia, Congenital (blood, diagnosis, therapy)
  • Adrenocorticotropic Hormone
  • Birth Weight
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature (blood)
  • Infant, Premature, Diseases (blood, diagnosis, therapy)
  • Reference Values
  • Treatment Outcome

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