Newborn screening levels of 17-hydroxyprogesterone in very low birth weight infants and the relationship to chronic lung disease.
OBJECTIVE
17-Hydroxyprogesterone (17-OHP), an intermediary hormone in cortisol synthesis, has been shown to be elevated in premature infants. However, the relationship between levels of 17-OHP with chronic lung disease (CLD) have not been extensively explored. The objective of this study was to determine whether there is an association between CLD and levels of 17-OHP in a population of very low birth weight infants.


METHODS
Cohort study of very low birth weight infants cared for at a single level 3 NICU during a 3-year period from July 2001-July 2004, n=435. Infants had a minimum of one screen for 17-OHP. 17-OHP was measured on the 5th day of life and at 2-4 weeks of life as part of the State of Delaware Newborn Screening Program. Statistical analysis included chi-squared, Pearson correlation, and logistic regression.


RESULTS
Levels of 17-OHP were higher at the time of the 1st screen compared to the 2nd screen (42.2 +/- 36.7 vs 23.5 +/- 32.3 ng/ml, respectively, p = 0.01). After controlling for potential confounding variables, gestational age and prenatal steroids were independently associated with 17-OHP. However, logistic regression analysis showed no association between a 1 log increase in levels of 17-OHP with the outcomes of CLD (odds ratio 1.7, 95% CI 0.7-3.8), or death and/or CLD (odds ratio 2.1, 95% CI 0.9-4.8).


CONCLUSIONS
In our population of very low birth weight infants elevated levels of 17-OHP were not associated with the development of CLD.
Pau
David A
DA
Department of Pediatrics, Section of Neonatology, Christiana Care Health System, Newark, DE 19718, USA. paul.d@christianancare.org
Mackley
Amy
A
Bartoshesky
Louis
L
D019326:17-alpha-Hydroxyprogesterone / Q000097:blood*; D015415:Biomarkers; D001724:Birth Weight; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000378:metabolism*; D008171:Lung Diseases / Q000097:blood / Q000175:diagnosis*; D008297:Male; D015997:Neonatal Screening; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D011650:Pulmonary Alveoli / Q000378:metabolism; D012121:Respiration, Artificial; D012129:Respiratory Function Tests; D016896:Treatment Outcome
D015415:Biomarkers; D019326:17-alpha-Hydroxyprogesterone; D010100:Oxygen