Faculty Opinions recommendation of Prenatal dexamethasone treatment of children at risk for congenital adrenal hyperplasia: the Swedish experience and standpoint.

2015 ◽  
Author(s):  
Phyllis Speiser
Keyword(s):  
At Risk ◽  
Congenital Adrenal Hyperplasia ◽  
Children At Risk ◽  
Adrenal Hyperplasia ◽  
Dexamethasone Treatment ◽  
Swedish Experience

scholarly journals MON-156 Efficacy and Safety of Prenatal Dexamethasone Treatment in Offspring at Risk for Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lizhen Xu ◽  
Wei Lin ◽  
Nengying Wang ◽  
Junping Wen ◽  
Gang Chen
Keyword(s):  
At Risk ◽  
Congenital Adrenal Hyperplasia ◽  
Behavioral Problems ◽  
Cognitive Functions ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Adrenal Hyperplasia ◽  
Dexamethasone Treatment ◽  
21 Hydroxylase Deficiency ◽  
Physical Outcomes

Abstract Objective: To assess the efficacy and safety of prenatal dexamethasone treatment in offspring at risk for congenital adrenal hyperplasia. Methods: MEDLINE, EMBASE, the Cochrane Library, the clinicaltrials.gov website databases was systematically searched from inception through March 2019. WMD and SMD with 95%CIs were calculated using random or fixed effects models. Results: There was a significant reduction of virilizationin the DEX-treated group (WMD: -2.39, 95%CI: -3.31,-1.47). No significant differences were found in newborn physical outcomes for birth weight (WMD: 0.09, 95%CI: -0.09, 0.27) and birth length (WMD= 0.27, 95%CI: -0.68, 1.21). Concerning cognitive functions, no significant differences in the domains of psychometric intelligence (SMD: 0.05, 95%CI: -0.74, 0.83), verbal memory (SMD: -0.17, 95%CI: -0.58, 0.23), visual memory (SMD: 0.10, 95%CI: -0.14, 0.34), learning (SMD: -0.02, 95%CI: -0.27, 0.22), verbal processing (SMD: -0.38, 95%CI: -0.93, 0.17). Regarding behavioral problems, no significant differences in the domains of internalizing problems (SMD: 0.16, 95%CI: -0.49, 0.81), externalizing problems (SMD: 0.07, 95%CI: -0.30, 0.43), total problems (SMD: 0.14, 95%CI: -0.23, 0.51). With respect to temperament, no significant differences in the domains of emotionality (SMD: 0.13, 95%CI: -0.79, 1.05), activity (SMD: 0.04, 95%CI: -0.32, 0.39), shyness (SMD: 0.25, 95%CI: -0.70, 1.20), sociability (SMD: -0.23, 95%CI: -0.90, 0.44). Conclusions: Prenatal DEX treatment reduced virilization with no significant differences in newborn physical outcomes, cognitive functions, behavioral problems, temperament. The results need to be interpreted cautiously due to the existence of limitations.

Cognitive Functions in Children at Risk for Congenital Adrenal Hyperplasia Treated Prenatally with Dexamethasone

2007 ◽  
Vol 62 (6) ◽  
pp. 382-384 ◽  
Author(s):  
Tatja Hirvikoski ◽  
Anna Nordenström ◽  
Torun Lindholm ◽  
Frank Lindblad ◽  
E Martin Ritzén ◽  
...  
Keyword(s):  
At Risk ◽  
Congenital Adrenal Hyperplasia ◽  
Cognitive Functions ◽  
Children At Risk ◽  
Adrenal Hyperplasia

scholarly journals Long-term follow-up of prenatally treated children at risk for congenital adrenal hyperplasia: does dexamethasone cause behavioural problems?

2008 ◽  
Vol 159 (3) ◽  
pp. 309-316 ◽  
Author(s):  
Tatja Hirvikoski ◽  
Anna Nordenström ◽  
Torun Lindholm ◽  
Frank Lindblad ◽  
E Martin Ritzén ◽  
...  
Keyword(s):  
At Risk ◽  
Social Anxiety ◽  
Congenital Adrenal Hyperplasia ◽  
Adaptive Functioning ◽  
Behavioural Problems ◽  
Children At Risk ◽  
Adrenal Hyperplasia ◽  
Long Term Follow Up

ObjectivesTo investigate the long-term effects of prenatal treatment of congenital adrenal hyperplasia (CAH) with emphasis on behavioural problems and temperament.DesignA population-based long-term follow-up study of Swedish children at risk for virilising CAH, who had received treatment prenatally with dexamethasone (DEX). The questionnaire-based follow-up was performed when the children had reached school age.MethodsStandardised parent-completed questionnaires were used to evaluate adaptive functioning, behavioural/emotional problems and psychopathology, social anxiety and temperament in DEX-exposed school-aged children (n=26) and matched controls (n=35). In addition, the association between parental questionnaires and children's self-ratings was investigated.ResultsThere were no statistically significant differences between DEX-exposed children and controls in measures of psychopathology, behavioural problems and adaptive functioning. In a questionnaire on temperamental traits, DEX-exposed children were described by their parents as being more sociable than controls (P=0.042). The correlation analysis showed only modest parent–child agreement on social anxiety, i.e. the increased social anxiety in children's self-ratings was not confirmed by their parents.ConclusionsDEX-treated children showed good overall adjustment. The parent–child agreement with respect to social anxiety was modest, highlighting the importance of multiple information sources and assessment methods. The clinical significance of the observed difference in sociability cannot be determined within the frameworks of this study. Additional studies of larger cohorts are essential to make more decisive conclusions on the safety of the treatment. Until then, it is important that parents are thoroughly informed about the benefits and potential risks and uncertainties of this controversial treatment.

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