Interpretation of screening for congenital adrenal hyperplasia in preterm infants.
10.3345/kjp.2008.51.6.616
- Author:
Hye Rim CHUNG
1
;
Choong Ho SHIN
;
Sei Won YANG
;
Kyong Ah YUN
;
Young Ah LEE
;
So Eun PARK
;
Chang Won CHOI
;
Byung Il KIM
;
Jung Hwan CHOI
;
Junghan SONG
Author Information
1. Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea. chshinpd@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Congenital adrenal hyperplasia;
Preterm;
Neonatal screening
- MeSH:
Adrenal Hyperplasia, Congenital;
Appointments and Schedules;
Bronchopulmonary Dysplasia;
Dexamethasone;
Follow-Up Studies;
Gestational Age;
Humans;
Hypotension;
Infant;
Infant, Newborn;
Infant, Premature;
Mass Screening;
Neonatal Screening
- From:Korean Journal of Pediatrics
2008;51(6):616-621
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was undertaken to identify factors that influence 17-OHP levels in preterm infants and to suggest a reasonable follow-up schedule of screening for congenital adrenal hyperplasia (CAH) in preterm infants. METHODS: The 17-OHP concentrations in filter paper blood spots of 427 preterm infants were obtained. The effects of gestational age (GA), systemic diseases, and antenatal dexamethasone on screening and follow-up 17-OHP values were investigated. RESULTS: The screening 17-OHP values were markedly variable (range: 0.1-143.3 ng/mL). The screening 17-OHP levels were negatively correlated with GA (r=-0.535, P<0.01). In infants with GA <32 weeks, the screening 17-OHP levels were significantly higher in sick infants or infant with hypotension than in healthy infants. The screening values of prenatal dexamethasone-treated infants had a tendency to be low. In infants with initial 17-OHP values > or =20 ng/mL, the intervals until rescreening 17-OHP <10 ng/mL or serum 17-OHP <20 ng/mL were negatively correlated with GA (r=-0.541, P<0.01) and were prolonged in infants with bronchopulmonary dysplasia (P<0.01). None of the preterm infants were confirmatively diagnosed with CAH. CONCLUSION: The 17-OHP values of preterm infants were influenced by GA, prenatal dexamethasone, and postnatal diseases. Because the 17-OHP vlues of preterm infants were markedly variable, a follow-up schedule should be developed considering both 17-OHP values and clinical status.
