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http://dx.doi.org/10.3345/kjp.2008.51.6.616

Interpretation of screening for congenital adrenal hyperplasia in preterm infants  

Chung, Hye Rim (Department of Pediatrics, Seoul National University, College of Medicine)
Shin, Choong Ho (Department of Pediatrics, Seoul National University, College of Medicine)
Yang, Sei Won (Department of Pediatrics, Seoul National University, College of Medicine)
Yun, Kyong Ah (Department of Pediatrics, Seoul National University, College of Medicine)
Lee, Young Ah (Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea)
Park, So Eun (Department of Pediatrics, Seoul National University, College of Medicine)
Choi, Chang Won (Department of Pediatrics, Seoul National University, College of Medicine)
Kim, Byung Il (Department of Pediatrics, Seoul National University, College of Medicine)
Choi, Jung Hwan (Department of Pediatrics, Seoul National University, College of Medicine)
Song, and Junghan (Department of Laboratory Medicine, Seoul National University, College of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.51, no.6, 2008 , pp. 616-621 More about this Journal
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 ${\geq}20ng/mL$, 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 values of preterm infants were markedly variable, a follow-up schedule should be developed considering both 17-OHP values and clinical status.
Keywords
Congenital adrenal hyperplasia; Preterm; Neonatal screening;
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