Prenatal dexamethasone use for the prevention of virilization in pregnancies at risk for classical congenital adrenal hyperplasia because of 21‐hydroxylase (CYP21A2) deficiency: a systematic review and meta‐analyses
@article{MercFernndezBalsells2010PrenatalDU, title={Prenatal dexamethasone use for the prevention of virilization in pregnancies at risk for classical congenital adrenal hyperplasia because of 21‐hydroxylase (CYP21A2) deficiency: a systematic review and meta‐analyses}, author={M Merc{\`e} Fern{\'a}ndez-Balsells and Kalpana Muthusamy and Galina Smushkin and Julianna F. Lampropulos and Mohamed B. Elamin and Nisrin O. Abu Elnour and Khalid B. Elamin and Neera Agrwal and Juan Fernando Gallegos-Orozco and Melanie A. Lane and Patricia J. Erwin and Victor M. Montori and M. Hassan Murad}, journal={Clinical Endocrinology}, year={2010}, volume={73} }
Context Prenatal treatment with dexamethasone to prevent virilization in pregnancies at risk for classical congenital adrenal hyperplasia (CAH) remains controversial.
68 Citations
Efficacy and safety of prenatal dexamethasone treatment in offspring at risk for congenital adrenal hyperplasia due to 21‐hydroxylase deficiency: A systematic review and meta‐analysis
- MedicineClinical endocrinology
- 2019
To assess the efficacy and safety of prenatal dexamethasone treatment in offspring at risk for congenital adrenal hyperplasia, a large number of cases have been reported to have benefited from treatment with this drug.
[Recommendations for the diagnosis and treatment of classic forms of 21-hydroxylase-deficient congenital adrenal hyperplasia].
- MedicineAnales de pediatria
- 2017
Prenatal Diagnosis of Congenital Adrenal Hyperplasia.
- MedicineEndocrinology and metabolism clinics of North America
- 2016
Challenges in Prenatal Treatment with Dexamethasone.
- MedicinePediatric endocrinology reviews : PER
- 2018
The short- and long-term outcomes for fetuses and pregnant women exposed to dexamethasone treatment, the ethical considerations that must be taken into account, and current practice recommendations are reviewed.
Preventing female virilisation in congenital adrenal hyperplasia: The controversial role of antenatal dexamethasone
- MedicineThe Australian & New Zealand journal of obstetrics & gynaecology
- 2016
Current controversies, potential improvements and future directions in the management of pregnancies at risk of CAH are summarized, including early prenatal diagnosis utilising noninvasive genetic techniques to minimise unnecessary dexamethasone exposure to unaffected fetuses.
Pregnancy in women with nonclassic congenital adrenal hyperplasia: Time to conceive and outcome
- MedicineClinical endocrinology
- 2017
The objective of this study was to evaluate the effect of glucocorticoid treatment on fertility and on pregnancy outcome in women with NCAH.
The importance and implications of preconception genetic testing for accurate fetal risk estimation in 21-hydroxylase congenital adrenal hyperplasia (CAH)
- MedicineGynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
- 2019
How the preconception genetic testing of a lady and her partner dramatically changed the estimated risk to their offspring and the major implications the results had on pregnancy planning are reported.
Fertility in patients with congenital adrenal hyperplasia.
- Medicine, BiologyFertility and sterility
- 2014
Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline.
- MedicineThe Journal of clinical endocrinology and metabolism
- 2018
Objective
To update the congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency clinical practice guideline published by the Endocrine Society in 2010.
Conclusions
The writing…
References
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Prenatal diagnosis by direct mutation detection in previously genotyped families permits prenatal treatment of affected females in order to avoid or minimize genital virilization, and the state of heterozygotism can be predicted by hormonal testing and confirmed by molecular studies.
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Prenatal diagnosis and proper prenatal treatment of 21-OHD are effective in significantly reducing or eliminating virilization in the newborn female, and spares the affected female the consequences of genital ambiguity, genital surgery, and possible sex misassignment.
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Proper prenatal diagnosis and treatment of 21-OHD is effective in significantly reducing or eliminating virilization in the affected female, which spares the newborn female the consequences of genital ambiguity, i.e. genital surgery, sex misassignment, and gender confusion.
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Experience to date suggests that prenatal treatment of affected female fetuses is generally efficient in minimizing virilization of external genitalia, however, there is still a need to collect more data concerning possible rare unfavorable effects of this therapy on mother and child.
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The clinical significance of the observed difference in sociability cannot be determined within the frameworks of this study, but additional studies of larger cohorts are essential to make more decisive conclusions on the safety of the treatment.
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The purpose of the present paper is to revisit the issue, review the status of the empirical evidence, especially the role of behavioral determinants, and suggest additional hormone-related psychological factors that may contribute to the low fertility rates of CAH women.
Cognitive functions in children at risk for congenital adrenal hyperplasia treated prenatally with dexamethasone.
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Prenatally treated, CAH-affected children performed poorer than controls on tests measuring verbal processing speed, although this difference disappeared when controlling for the child's full-scale IQ.
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