All issues > Volume 51(6); 2008

Original Article

Korean J Pediatr. 2008;51(6):616-621. Published online June 15, 2008.

Interpretation of screening for congenital adrenal hyperplasia in preterm infants

Hye Rim HR Chung¹, Choong Ho CH Shin¹, Sei Won SW Yang¹, Kyong Ah KA Yun¹, Young Ah YA Lee¹, So Eun SE Park¹, Chang Won CW Choi¹, Byung Il BI Kim¹, Jung Hwan JH Choi¹, Junghan JH Song²

¹Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
²Department of Laboratory Medicine, Seoul National University, College of Medicine, Seoul, Korea

Correspondence Choong Ho CH Shin ,Email: chshinpd@snu.ac.kr

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 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 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