Document Detail

Risk factors for elevated levels of 17-hydroxyprogesterone during neonatal intensive care unit admission.
MedLine Citation:
PMID:  22712163     Owner:  NLM     Status:  MEDLINE    
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.
G Pauwels; K Allegaert; L Régal; A Meulemans
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta clinica Belgica     Volume:  67     ISSN:  1784-3286     ISO Abbreviation:  Acta Clin Belg     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-06-20     Completed Date:  2012-07-24     Revised Date:  2014-03-18    
Medline Journal Info:
Nlm Unique ID:  0370306     Medline TA:  Acta Clin Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  88-93     Citation Subset:  IM    
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MeSH Terms
17-alpha-Hydroxyprogesterone / blood*
Adrenal Hyperplasia, Congenital / diagnosis
Gestational Age
Infant, Newborn
Intensive Care Units, Neonatal
Retrospective Studies
Risk Factors
Reg. No./Substance:

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