Pregnancy in women with nonclassic congenital adrenal hyperplasia: Time to conceive and outcome
| Autor: | Anat Segev-Becker, Irit Ayalon-Dangur, Shoshana Israel, Anita Schachter-Davidov, Ori Eyal, Naomi Weintrob |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Endocrinology Diabetes and Metabolism Population 030209 endocrinology & metabolism Miscarriage Young Adult 03 medical and health sciences 0302 clinical medicine Endocrinology Pregnancy Internal medicine medicine Humans Congenital adrenal hyperplasia Birth Rate education Glucocorticoids Retrospective Studies education.field_of_study 030219 obstetrics & reproductive medicine Adrenal Hyperplasia Congenital business.industry Virilization Pregnancy Outcome medicine.disease Ashkenazi jews Pregnancy rate Fertility Female medicine.symptom Live birth business |
| Zdroj: | Clinical Endocrinology. 87:552-556 |
| ISSN: | 0300-0664 |
| DOI: | 10.1111/cen.13429 |
| Popis: | SummaryObjective Non-classic congenital adrenal hyperplasia (NCAH) is common among Ashkenazi Jews (1:400). It is associated with various degrees of postnatal virilization, irregular menses and infertility. Therapy of symptomatic subjects consists of physiologic doses of glucocorticoids. The objective of this study was to evaluate the effect of glucocorticoid treatment on fertility and on pregnancy outcome in women with NCAH. Design, Setting and Patients This retrospective study included 75 women diagnosed with NCAH who were followed in our clinic and sought fertility between 2008 and 2015. Results Seventy-two women succeeded in conceiving (187 pregnancies). Time to conception was 4.0±7 months without and 3.3±3 months with glucocorticoid therapy (P=0.43). Seventeen pregnancies were achieved by glucocorticoid therapy after failure to conceive spontaneously. Time to conception before therapy initiation was 10.2±11.4 months compared to 3.3 ± 3.4 months after therapy initiation (P=0.02). Out of 187 pregnancies, 135 (72%) resulted in live births, 38 (20.3%) ended in spontaneous miscarriages during the first trimester, 7 (3.7%) were electively terminated, 3 (1.6%) were ectopic, and 4 (2.1%) were ongoing during the study with similar rate in glucocorticoid treated and untreated pregnancies. Conclusions The 96% pregnancy rate among our cohort of NCAH females was similar to the 95% rate reported for the normal population. Glucocorticoid therapy may shorten the time to conceive in a subgroup of women with NCAH. Glucocorticoid therapy did not affect the rate of first trimester miscarriage. Our 77% live birth rate was similar to the 72% live birth rate in the current healthy US population This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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