Analysis of influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates
Objective To explore the influencing factors on screening cut-off value of congenital adrenal hyperplasia in neonates.Methods A total of 171 live-born neonates admitted to Shunde Women and Children's Hospital of Guangdong Medical University from August 2020 to October 2021 were selected for in-depth analysis.Their heel blood were collected to measure the concentration of 17-hydroxyprogesterone(17-OHP),the effects of different gestational ages and body masses on the generation of 17-OHP were analyzed,and the cut-off value was calculated.Results 51 cases were positive in the preliminary screening,with 41 cases(80.39％)of premature infants and 10 cases(19.61％)of full-term infants,respectively.Among them,24 cases were positive in the re-examination.Among children with different gestational ages,premature infants have higher concentrations of 17-OHP,with the difference was statistically significant(P<0.05).Among children with different birth weights,the concentrations of 17-OHP were higher in low birth weight infants,with the difference was statistically significant(P<0.05).Through multiple linear regression analysis,it was found that gestational age,birth weights were risk factors affecting 17-OHP concentration levels.The negative impact of gestational age on 17-OHP concentration levels was more significant,with the difference was statistically significant(P<0.05).Compared with kit screening,the 99.9th percentile(P99.9)screening rate of premature infants was lower,with the difference was statistically significant(P<0.05).Conclusion Gestational age and birth weights are closely related to 17-OHP concentration levels,thus the 17-OHP cut-off value can be established based on gestational age,and the false positive rate can be significantly reduced.
万方数据
维普
