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Hormone modeling in preterm neonates: establishment of pituitary and steroid hormone reference intervals

Ronda F Greaves1, Janne Pitkin, Chung Shun Ho

  • 1School 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.

The Journal of Clinical Endocrinology and Metabolism
|January 7, 2015
PubMed

Insights

This study establishes reference intervals for eight hormones in preterm infants, crucial for accurate diagnosis and care. These findings aid in interpreting hormone levels for very preterm neonates, reducing misdiagnosis risks.

Area of Science:

  • Neonatal endocrinology
  • Pediatric clinical chemistry

Background:

  • Significant differences exist in serum hormone levels between preterm and full-term infants.
  • Accurate interpretation of hormone levels is critical for managing preterm neonates.

Purpose of the Study:

  • To establish reference intervals (RIs) for 3 pituitary and 5 steroid hormones in preterm infants.
  • To provide a basis for accurate clinical interpretation of hormone measurements in this population.

Main Methods:

  • Serum samples from 248 preterm neonates (24-32 weeks' gestation) were analyzed.
  • Pituitary hormones (prolactin, FSH, LH) measured by immunoassay; steroid hormones (17-hydroxyprogesterone, androstenedione, cortisol, cortisone, testosterone) by liquid chromatography-tandem mass spectrometry.
  • Robust statistical methods, including Box-Cox transformation, were used to define central 95% RIs.

Main Results:

  • Reference intervals were established for 8 hormones.
  • Gender-specific RIs for FSH, LH, and testosterone.
  • Cortisone and 17-hydroxyprogesterone RIs were dependent on gestational age (<30 weeks).

Conclusions:

  • This study presents the first characterization of serum steroids by mass spectrometry and pituitary hormones in preterm neonates (≤32 weeks' gestation).
  • These established RIs are vital for correct interpretation of results in very preterm infants.
  • The data will help reduce diagnostic errors stemming from misinterpretation of hormone levels.
Abstract

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