Abstract
Introduction: Prenatal maternal betamethason administration to induce lung maturation might subsequently interfere with neonatal screening of congenital adrenal hyperplasia (CAH). We therefore evaluated the impact of prenatal betamethason and other risk factors on 17-hydroxyprogesterone (17- OHP) in filter-paper blood.
Methods: Retrospective collection of clinical characteristics (birth weight, gestational age, small for gestational age, prenatal betamethason, day of sampling, duration respiratory support) in neonates admitted in a single NICU and with an increased 17-OHP (>30umol/L) at initial screening that turned out to be false positive. Data reported by median and range or incidence. Clinical characteristics were compared with individual 17-OHP (correlation, Mann Withney U, multiple regression).
Results: In 91 (median 73, range 31-463 umol/L) cases, BW, GA, SGA, prenatal betamethason, day of sampling were 1500 (370-3660) g, 30 (25-40) wks, 6/91, 54/91 and 3 (2-23) days respectively. Significant correlations between 17-OHP and BW (r = -0.69, p < 0.001) and GA (r= -0.67, p < 0.001) were observed. Median 17-OHP was higher in cases treated with betamethason (85.5 vs 57 umol/L, p< 0.0001). In a multiple regression model, GA remained the only independent variable. To further elaborate the association between betamethason and 17OHP, a case-control (GA) study was performed. No significant difference (paired) in incidence of betamethasone administration was observed (54/91 vs 37/91, p=0.2).
Conclusions: Maternal betamethasone administration is associated with raised 17-OHP at screening, but can be explained by the lower gestational age. Gestational age is the only independent variable associated with further raised 17OHP in a cohort of false positive screening samples.
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Pauwels, G., Meulemans, A., Allegaert, K. et al. 1255 Maternal Betamethason Administration is An Indicator But Not An Independent Risk Factor for Raised 17-Hydroxyprogesterone at Neonatal Screening. Pediatr Res 68 (Suppl 1), 621–622 (2010). https://doi.org/10.1203/00006450-201011001-01255
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DOI: https://doi.org/10.1203/00006450-201011001-01255