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Medline ® Abstract for Reference 39

of 'Evaluation of the infant with atypical genitalia (disorder of sex development)'

39
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Hormone modeling in preterm neonates: establishment of pituitary and steroid hormone reference intervals.
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Greaves RF, Pitkin J, Ho CS, Baglin J, Hunt RW, Zacharin MR
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J Clin Endocrinol Metab. 2015 Mar;100(3):1097-103. Epub 2015 Jan 6.
 
CONTEXT: Reports suggest significant differences in serum levels of hormones in extremely preterm compared with late preterm and full-term infants.
OBJECTIVES: The purpose of this study was to develop reference intervals (RIs) for 3 pituitary hormones and 5 steroid hormones in serum of preterm infants.
DESIGN: Blood samples were collected from 248 (128 male and 120 female) preterm neonates born between 24 and 32 weeks' gestation.
SETTING: PARTICIPANTS were recruited from 3 neonatal intensive care wards in Melbourne, Australia.
PARTICIPANTS: No infant in this cohort had ambiguous genitalia or other endocrine abnormalities. All infants included in the RI determination survived beyond the equivalent of term.
INTERVENTIONS: Serum was analyzed for prolactin, FSH, and LH by automated electrochemiluminescence immunoassay (Roche Cobas 8000-e601). Liquid chromatography coupled with tandem mass spectrometry was used for analysis of 17-hydroxyprogesterone, androstenedione, cortisol, cortisone, and testosterone.
MAIN OUTCOME MEASURES: The robust method was applied to define the central 95% RI, after each hormone measure was transformed using a Box-Cox transformation to correct for asymmetry.
RESULTS: RIs were established for 8 hormones. Gender-specific intervals were developed for FSH, LH, and testosterone. Cortisone and 17- hydroxyprogesterone required division based on gestational age, with neonates born at<30 weeks' gestation demonstrating higher levels than their older counterparts. Androstenedione, cortisol, and prolactin did not require any division within this cohort for RI assignment.
CONCLUSIONS: This report provides the first characterization of serum steroids measured by mass spectrometry in preterm neonates, with the additional characterization of 3 pituitary hormones in infants born at≤32 weeks' gestation. Use of these data allows for correct interpretation of results for very preterm neonates and reduces the risk of incorrect diagnosis due to misinterpretation of data.
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School of Medical Sciences (R.F.G.) and School of Mathematical and Geospatial Sciences (J.B.), RMIT University, Victoria 3000, Australia; Murdoch Children's Research Institute (R.F.G., J.P., R.W.H., M.R.Z.), Melbourne, Victoria 3052, Australia; Prince of Wales Hospital (C.S.H.), Shatin, New Territories, Hong Kong SAR; Department of Newborn Intensive Care (R.W.H.) and Department of Endocrinology and Diabetes (M.R.Z.), The Royal Children's Hospital, Parkville, Victoria 3052, Australia; and Department of Paediatrics (R.W.H., M.R.Z.), University of Melbourne, Parkville, Victoria 3010, Australia.
PMID