Screening for congenital adrenal hyperplasia: the Delfia Screening Test overestimates serum 17-hydroxyprogesterone in preterm infants.
OBJECTIVE
To compare 17-hydroxyprogesterone (17-OHP) levels measured by quantitative serum radioimmunoassay (RIA), including an extraction step, and by screening fluoroimmunoassay (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 micrograms/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(delta FIA-RIA) was inversely related to postconceptional age (R2 = .39).


CONCLUSIONS
Screening FIA of blood spots overestimates levels of 17-OHP in preterm infants and should not be used to determine the likelihood of congenital adrenal hyperplasia in this population. We have abandoned FIA screening for congenital adrenal hyperplasia in infants weighing less than 1500 g.
Department of Paediatrics, University of Manitoba, Winnipeg, Canada.
S
S
al Saedi
H
H
Dean
W
W
Dent
E
E
Stockl
C
C
Cronin
D019326:17-alpha-Hydroxyprogesterone; D000312:Adrenal Hyperplasia, Congenital / Q000097:blood* / Q000175:diagnosis; D000367:Age Factors; D015982:Bias; D005260:Female; D015200:Fluoroimmunoassay; D006801:Humans; D006908:Hydroxyprogesterones / Q000097:blood*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D015997:Neonatal Screening / Q000379:methods* / Q000592:standards; D011863:Radioimmunoassay; D015203:Reproducibility of Results
D006908:Hydroxyprogesterones; D019326:17-alpha-Hydroxyprogesterone