Cognitive and social function in girls with congenital adrenal hyperplasia - Influence of prenatally administered dexamethasone

• Published in: Child neuropsychology Vol. 20; no. 1; pp. 60 - 70
• Main Authors: Maryniak, Agnieszka, Ginalska-Malinowska, Maria, Bielawska, Alicja, Ondruch, Agnieszka
• Format: Journal Article
• Language: English
• Published: Colchester Routledge 02-01-2014; Taylor & Francis
• Subjects: Adrenal Hyperplasia, Congenital - drug therapy; Adrenal Hyperplasia, Congenital - psychology; Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Biological and medical sciences; Child; Child Behavior; Child clinical studies; Child Development - drug effects; Cognition - drug effects; Cognitive development; Cognitive functions; Congenital adrenal hyperplasia; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Drug Administration Schedule; Endocrinopathies; Female; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Humans; Male; Medical sciences; Memory - drug effects; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Organic mental disorders. Neuropsychology; Pregnancy; Prenatal Exposure Delayed Effects; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Social Behavior; Social functions; Endocrinopathy; Social functions; Adrenal cortex diseases; Cognitive ability; Cognition; Hyperadrenocorticism; Enzymopathy; Social development; Social behavior; Adrenal gland diseases; Female; Social aptitude; Child; Human; Corticosteroid; Dexamethasone; Steroid hormone; Antiinflammatory agent; Congenital adrenal hyperplasia syndrome; Social interaction; Cognitive functions; Adolescent; Young adult; Cognitive development; Congenital adrenal hyperplasia
• ISSN: 0929-7049; 1744-4136
• DOI: 10.1080/09297049.2012.745495

Objectives: To assess the cognitive, social, and emotional function in girls prenatally treated with dexamethasone (Dex) due to congenital adrenal hyperplasia (CAH), compared to CAH female patients not treated prenatally.
Patients and methods: 33 girls from CAH families were studied: 17 girls treated prenatally with Dex (9 CAH-affected and 8 non-CAH-affected) and 16 CAH-affected females prenatally untre-ated. Standardized tests to assess cognitive function, tests of memory and learning process, and the Child Behavior Checklist (CBCL) were used.
Results: There were few statistically significant differences between the results of treated girls (CAH-affected and unaffected) and CAH untreated patients, with a tendency for better results in all tests by Dex treated girls. Among three groups- "CAH-unaffected treated," "CAH-affected treated," and "CAH-affected untreated"- the best results were found in "CAH-affected treated" in almost all tests. The Wechsler test performance scale was significantly higher in treated CAH-affected girls. The comparison between treated and untreated CAH-affected girls revealed better results in all tasks involving the cognitive function in Dex-treated patients. Poor performance in visual perception, analysis of spatial material, and visual memory tasks were obtained in CAH-unaffected treated girls.
Conclusions: Prenatal treatment with Dex creates for CAH-affected females better conditions for cognitive development. The prenatal Dex in CAH-unaffected girls can cause the risk of unfavorable influences on the development of some cognitive functions. Therefore, it is recommended that prenatal treatment in CAH-unaffected female fetuses should be stopped as soon as possible after the exclusion of the disease.