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J Korean Pediatr Soc. 1999 Dec;42(12):1717-1724. Korean. Original Article.
Kim SS , Song SM , Park EJ , Kim JS , Jang YS , Park WS , Kim JW , Kim SW , Uhm MR , Ko SH , Jin DK .
Department of Pediatrics, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Samsung Jeil Hospital.
Department of Clinicopathology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Samsung Jeil Hospital.
Samsung Medical Research, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Samsung Jeil Hospital.
Department of Pediatrics, College of Medicine, Dankook University, Seoul, Korea.
Abstract

PURPOSE: Congenital adrenal hyperplasia(CAH), which is classified into salt-wasting, simple virilization and non-classic type according to clinical features, is difficult to detect in early stages. Failure to diagnose it in the initial state may lead to life-threatening adrenal crisis, inappropriate male sex assignment in the genetic female, acceleration of skeletal maturation and subsequent short stature. Therefore, we studied the variables increasing the 17-hydroxyprogesterone(OHP) values for more specific and sensitive diagnosis of CAH. METHODS: We classified 3,532 newborns into variable factors; gestational age, birth weight, gender, delivery type, sampling date and stress. Then, we analysed the relationships between 17-OHP values and variable factors. RESULTS: The mean value of 17-OHP was 4.21+/-0.03ng/ml. There were significant differences among the variable factors except gender. The mean value of male was 4.26ng/ml, and that of female was 4.15ng/ml(P=0.10). The mean value of 17-OHP in vaginal delivered newborn was higher than C-section delivered ones(4.71ng/ml, 3.34ng/ml, P=0.0001). It was also higher in low birth weight(P=0.0001), in prematurity(P=0.001), those sampled within 4 days(P=0.0001), stressful condition and ventilator care-assisted(P=0.004). CONCLUSION: 17-OHP value in neonatal screening is influenced by several variables such as vaginal delivery, ventilator management, low birth weight, sampling date and prematurity. If the 17-OHP value is increased, we have to consider the variables influencing the increase in value and follow up with time interval or analysis of genetic mutations.

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