Women With Congenital Adrenal Hyperplasia Have Favorable Pregnancy Outcomes but Prolonged Time to Conceive.

Auer, Matthias K; Minea, Clara E; Quinkler, Marcus; Bancos, Irina; Beuschlein, Felix; Meyer, Gesine; Lottspeich, Christian; Bidlingmaier, Martin; Rieger, Eva; Nowotny, Hanna F; Tschaidse, Lea; Falhammar, Henrik; Pivonello, Rosario; Simeoli, Chiara; Reisch, Nicole

Objective To study pregnancy outcomes and complications in women with congenital adrenal hyperplasia (CAH). Methods A retrospective multicenter study was conducted at tertiary reference centers in 5 countries (Austria, Germany, Italy, Sweden, USA), including 72 adult women with CAH (nonclassic [NC] n = 34, simple virilizing [SV] n = 21, salt wasting [SW] n = 17). Results A total of 133 pregnancies, 112 live births, and 25 abortions were documented. Prolonged latency to pregnancy was observed (median 11 months in SW, 24 months in SV, 8 months in NC), with a notable use of fertility-enhancing medication (25.6%) and assisted reproductive techniques (30.8%). Over half of the women in each group took more than 12 months to conceive. The average number of live births (1.4-1.6 children per woman) was similar across CAH phenotypes and comparable to the general population. Spontaneous abortion rates (18.0%) were also similar across phenotypes. Primary cesarean section rates (60.9%) were higher than in the general population, though 23.8% of women with SV and 29.4% of women with SW gave birth naturally, despite most having undergone genital surgery. Children categorized as small for gestational age were 20.5%. Pregnancy, delivery, and postpartum complications were rare for mothers and neonates. Conclusion The study indicates a prolonged latency to pregnancy and high use of fertility treatments in CAH patients, regardless of phenotype. Abortion rates were not increased, and overall pregnancy and perinatal outcomes were favorable.

ADRENOGENITAL syndrome; PREGNANCY outcomes; ABORTION; PREGNANCY complications; MISCARRIAGE

Journal of the Endocrine Society, 2025, Vol 9, Issue 1, p1

2472-1972

Academic Journal

10.1210/jendso/bvae211