7-Hydroxyprogesterone values in healthy preterm newborns screened at the Maternity and Neonatology University Hospital
Congenital Adrenal Hyperplasia (CAH) is a group of steroidogenesis disorders caused by enzymatic defects in the pathway of glucocorticoid and/or mineralocorticoid synthesis. It is characterized by cortisol deficiency, androgen excess, and occasionally aldosterone deficiency with salt loss. This...
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| Autores principales: | , , , , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2025
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/50349 |
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| Sumario: | Congenital Adrenal Hyperplasia (CAH) is a group of steroidogenesis disorders caused by enzymatic defects in the pathway of glucocorticoid and/or mineralocorticoid synthesis. It is characterized by cortisol deficiency, androgen excess, and occasionally aldosterone deficiency with salt loss. This condition is included in neonatal screening, reducing morbidity and mortality in newborns (NB). 17α-hydroxyprogesterone (17-OHP), the biochemical marker for diagnosis and follow-up of patients with CAH, is influenced by gestational age (GA), chronological age (CA), sex, birth weight (BW), stress, illness, and interfering steroids. Therefore, a second measurement should be performed at 15 days of life. The objective was to describe 17-OHP values adjusted for BW in preterm newborns (PTNB), to compare values obtained in the first and second sample collection, and to assess their association with maternal history.
Samples from PTNB screened for CAH between 08/04/2023 and 07/17/2024 at CEPIDEM, Maternity and Neonatology University Hospital, were analyzed. This retrospective cross-sectional study included 42 PTNB divided into two groups: G1: 23 PTNB, BW ≤ 2500g, and G2: 16 PTNB, BW > 2500g. Determination of 17-OHP in dried blood spots was performed by ELISA at birth (1stS) and at 15 days of life (2ndS). The cutoff value for 17-OHP in term newborns (TN) is <30 ng/mL.
The 17-OHP values (ng/mL) were: G1, 1stS 25.8 ± 18.1 and 2ndS 16.9 ± 4.5; G2, 1stS 16.6 ± 5.5 and 2ndS 14.3 ± 2.8, showing significant differences in both groups (p<0.001). 17-OHP values were higher in PTNB compared to TN, with greater elevations in G1. A decrease in 17-OHP values was observed at 2ndS in both groups. Maternal history revealed increased substance abuse, which could contribute to prematurity.
Study limitations included the small number of NB per group and incomplete medical records. Adjusting 17-OHP values for BW is useful to improve diagnostic specificity, reduce false positives, and decrease the rate of recalls for the 2ndS.
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