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Annals of Clinical & Laboratory Science 38:235-240 (2008)
© 2008 Association of Clinical Scientists

Corrected 17-Alpha-Hydroxyprogesterone Values Adjusted by a Scoring System for Screening Congenital Adrenal Hyperplasia in Premature Infants

Ji Eun Lee1, Yeonsook Moon2, Moon Hee Lee3, Yong Hoon Jun1, Kyung Il Oh1 and Jong Weon Choi2
1 Departments of Pediatrics, 2 Laboratory Medicine, and 3 Medicine (Division of Hematology-Oncology), College of Medicine, Inha University, Incheon, South Korea

Address correspondence to Jong Weon Choi, M.D., Ph.D., Department of Laboratory Medicine, Inha University Hospital, 7-206, 3-ga, Shinheung-dong, Jung-gu, Incheon, 400-711, South Korea; tel 82 32 890 2503; fax 82 32 890 2529; e-mail jwchoi{at}inha.ac.kr.

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.

Keywords: congenital adrenal hyperplasia, 17-alpha-hydroxyprogesterone in blood spots, 21-hydroxylase deficiency, neonatal screening, premature infants, prematurity index






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