Determination of Variation in Neonatal Serum 17 Hydroxyprogesterone Levels in Relation with Gestational Age & Low Birth Weight

Abstract

Objective: To determine the variation in neonatal Serum 17 – hydroxyprogesterone levels in newborns in accordance with the birth weight and gestational age. Study Design:It was an analytical cross-sectional study. Place and Duration of Study: The study was carried out at Armed Forces Institute of Pathology Rawalpindi. The duration of study was 6 months i.e., 17 Nov, 2021 – 17 May, 2022 after the approval from Institutional Review Board (FC-CHP21-12/Read-IRB/22/845). Materials and Methods: A sum of 210 individuals were included by convenient non-probability sampling technique and divided into 3 groups. Group I included 70 neonates which were delivered at full term (38 – 40) weeks of gestation) with birth weight of 2500 – 4000 g as healthy controls. Group II included 70 neonates delivered at 32 - 37 weeks of gestation with birth weight of 1500 – 2500 g. Group III included 70 neonates delivered at 28 – 32 weeks of gestation with less than 1500 g weight at the time of birth. Results: The gender-wise distribution of patients, was with males accounting for 65% and females for 35%. The mean value of Serum 17 hydroxyprogesterone (17 – OHP) exhibited a significant increase in Group III (118+8.05 nmol/l), followed by Group II (58+15.66 nmol/l), while Group I had normal levels (21+8.08 U/l) as shown in Figure II. After conducting a one-way ANOVA, post-hoc Tukey analysis was performed to compare three study groups. The Tukey HSD q statistics revealed significant differences between Group I and Group II (72.86), Group I and Group III (180.8), and Group II and Group III (107.95), all with a p-value of < 0.01. Significance in terms of statistics was determined by considering a Tukey HSD p-value below 0.05. Data was analyzed on SPSS version 23. Conclusion: Neonatal Serum 17 – hydroxyprogesterone levels vary in accordance with the birth weight and gestational age. False-positive newborn-screening rates are disproportionately increased in prematurity and low birth weight. The optimal cut of levels adjusted to birth weight and gestational age of Serum 17 –hydroxyprogesterone should be established for screening of patients of congenital adrenal hyperplasia.

Keywords

• birth weight (bw), congenital adrenal hyperplasia (cah), 17 hydroxyprogesterone (17-ohp), gestational age (ga).