Variables Influencing 17-Hydroxyprogesterone Values in Newborn Screening for Congenital Adrenal Hyperplasia.
- Author:
Seong Seop KIM
1
;
Sung Mi SONG
;
Eun Jung PARK
;
Jung Sim KIM
;
Yun Sil JANG
;
Won Sun PARK
;
Jong Won KIM
;
Sun Woo KIM
;
Mie Ryung UHM
;
Si Hwan KO
;
Dong Kyu JIN
Author Information
1. Department of Pediatrics, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Samsung Jeil Hospital.
- Publication Type:Original Article
- Keywords:
Congenital adrenal hyperplasia(CAH);
17-Hydroxyprogesterone(17-OHP);
Vaginal delivery;
C-section delivery;
Prematurity
- MeSH:
17-alpha-Hydroxyprogesterone*;
Acceleration;
Adrenal Hyperplasia, Congenital*;
Birth Weight;
Diagnosis;
Female;
Follow-Up Studies;
Gestational Age;
Humans;
Infant, Low Birth Weight;
Infant, Newborn*;
Male;
Mass Screening*;
Neonatal Screening;
Parturition;
Ventilators, Mechanical;
Virilism
- From:Journal of the Korean Pediatric Society
1999;42(12):1717-1724
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Congenital adrenal hyperplasia(CAH), which is classified into salt-wasting, simple virilization and non-classic type according to clinical features, is difficult to detect in early stages. Failure to diagnose it in the initial state may lead to life-threatening adrenal crisis, inappropriate male sex assignment in the genetic female, acceleration of skeletal maturation and subsequent short stature. Therefore, we studied the variables increasing the 17-hydroxyprogesterone(OHP) values for more specific and sensitive diagnosis of CAH. METHODS: We classified 3,532 newborns into variable factors; gestational age, birth weight, gender, delivery type, sampling date and stress. Then, we analysed the relationships between 17-OHP values and variable factors. RESULTS: The mean value of 17-OHP was 4.21+/-0.03ng/ml. There were significant differences among the variable factors except gender. The mean value of male was 4.26ng/ml, and that of female was 4.15ng/ml(P=0.10). The mean value of 17-OHP in vaginal delivered newborn was higher than C-section delivered ones(4.71ng/ml, 3.34ng/ml, P=0.0001). It was also higher in low birth weight(P=0.0001), in prematurity(P=0.001), those sampled within 4 days(P=0.0001), stressful condition and ventilator care-assisted(P=0.004). CONCLUSION: 17-OHP value in neonatal screening is influenced by several variables such as vaginal delivery, ventilator management, low birth weight, sampling date and prematurity. If the 17-OHP value is increased, we have to consider the variables influencing the increase in value and follow up with time interval or analysis of genetic mutations.
