| Risk factors for elevated levels of 17-hydroxyprogesterone during neonatal intensive care unit admission. | |
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MedLine Citation:
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PMID: 22712163 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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INTRODUCTION: Screening for congenital adrenal hyperplasia (CAH) by measurement of 17-hydroxyprogesterone (17-OHP) in dried blood spots results in a high false positive rate among preterm newborns admitted in a neonatal intensive care unit (NICU). We searched for risk factors of this population for raised 17-OHP levels. METHODS: We retrospectively collected clinical characteristics (prenatal, at birth, postnatal) in newborns with an increased 17-OHP level at initial screening (> 30 nmol/L for a birth weight > 2000 g and > or = 60 nmol/L for a birth weight < or = 2000 g), that turned out to be false positive (no CAH). The correlation of these characteristics with individual 17-OHP levels was evaluated. We also performed a case-control study matched for gestational age (GA). RESULTS: In 94 screened newborns 17-OHP levels were raised at initial screening. Negative correlations were found between 17-OHP levels and GA and birth weight, positive correlations with prenatal betamethasone administration and several parameters of respiratory disease. In a multiple regression model GA was the dominant variable. In the case control study with 91 index patients admitted to the NICU (91/1275 newborns admitted to the NICU, 7.1%) a positive correlation with respiratory disease was confirmed and cases had a significant higher birth weight and a significant lower incidence of prenatal betamethasone administration. Application of new cutoff tables adjusted by GA and/or day of sampling would have resulted in a reduction in false positive rate. CONCLUSION: The dominant risk factor for a false positive screening during NICU admission is GA. Prenatal administration of betamethasone and birth weight are more complex risk factors. These observations support the use of new cut-off values based on GA to reduce the problem of false positive screening. |
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Authors:
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G Pauwels; K Allegaert; L Régal; A Meulemans |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta clinica Belgica Volume: 67 ISSN: 0001-5512 ISO Abbreviation: Acta Clin Belg Publication Date: 2012 Mar-Apr |
Date Detail:
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Created Date: 2012-06-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370306 Medline TA: Acta Clin Belg Country: Belgium |
Other Details:
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Languages: eng Pagination: 88-93 Citation Subset: IM |
Affiliation:
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Neonatale intensieve zorgen, Universitair Ziekenhuis Leuven, Leuven, Belgium. greet.pauwels@student.kuleuven.be |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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