Prenatal Diagnosis and Treatment of Congenital Adrenal Hyperplasia

Abstract

Prenatal dexamethasone treatment of congenital adrenal hyperplasia (CAH) has proven effective at reducing virilization of the external genitalia in affected girls if started before gestational week 7. Prenatal administration of glucocorticoids may, however, have adverse effects, which fact has raised concerns about the long-term safety of the treatment. Most of the evidence points toward negative effects on executive functions in children without CAH, and girls seem to be more vulnerable than boys. Early diagnosis avoids treatment in boys and healthy children but still involves the dilemma concerning full-term treatment of girls with CAH and the risks that this may lead to. Larger and long-term studies are needed to investigate a wide spectrum of health related issues, besides the outcomes already observed regarding cognition and behavior.