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. 
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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
TLDR
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].
Recommendations for the diagnosis and treatment of classic forms of 21-hydroxylase-deficient congenital adrenal hyperplasia
Prenatal Diagnosis of Congenital Adrenal Hyperplasia.
Challenges in Prenatal Treatment with Dexamethasone.
TLDR
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
TLDR
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
TLDR
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)
  • Suresh Rama Chandran, L. Loh
  • Medicine
    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
  • 2019
TLDR
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.
Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline.
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…
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References

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TLDR
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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TLDR
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.
Prenatal treatment and diagnosis of congenital adrenal hyperplasia owing to steroid 21-hydroxylase deficiency.
TLDR
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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TLDR
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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TLDR
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TLDR
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.
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TLDR
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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