PEDIATRICS Vol. 97 No. 1 January 1996, pp. 100-102
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Screening for Congenital Adrenal Hyperplasia: The Delfia Screening Test Overestimates Serum 17-Hydroxyprogesterone in Preterm Infants

Saad Al Saedi MD, FRCPC1, Heather Dean MD, FRCPC2, William Dent MSC3, Elizabeth Stockl RT4, and Catherine Cronin MD, FRCPI, FRCPC, FAAP1

1 Department of Paediatrics, Sections of Neonatology, University of Manitoba, Winnipeg
2 Department of Paediatrics, Paediatric Endocrinology, University of Manitoba, Winnipeg
3 Department of Paediatrics, Division of Laboratory Medicine and Pathology, Health Sciences Centre, University of Manitoba, Winnipeg
4 Department of Paediatrics, Cadham Provincial Laboratory, University of Manitoba, Winnipeg

Objective. To compare 17-hydroxyprogesterone (17-OHP) levels measured by quantitative serum radioimmunoassay (RIA), including an extraction step, and by screening fluoroimmnoassay (FIA) on blood spots in preterm infants.

Methods. Subjects were 39 healthy infants born at less than 31 weeks' gestational age. Each infant had weekly blood sampling, and RIA and FIA were performed on each sample.

Results. Two hundred twenty-seven samples were taken at 28 to 41 weeks' postconceptional age. Mean ± SD 17-OHP measured by RIA was 11.4 ± 11.1 nmol/L (0.4 ± 0.4 µg/dL), and decreased over time. Mean ± SD 17-OHP measured by FIA was 38.96 ± 37.3 nmol/L, greater than 17-OHP (RIA). Log(dgrFIA-RIA) was inversely related to postconceptional age (R2 = .39).

Conclusion. Screening FIA of blood spots overestimates levels of 17-OHP in preterm infants and should not be used to determine the likelthood of congenital adrenal hyperplasia in this population. We have abandoned FIA screening for congenital adrenal hyperplasia in infants weiging less than 1500 g.

Submitted on December 12, 1994
Accepted on February 21, 1995




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