Reassessing fecundity in women with classical congenital adrenal hyperplasia (CAH): normal pregnancy rate but reduced fertility rate
Reassessing fecundity in women with classical congenital adrenal hyperplasia (CAH): normal pregnancy rate but reduced fertility rate
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DOI：
10.1111/j.1365-2265.2009.03563.x
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发表时间：
2009-06-01
影响因子：
3.2
通讯作者：
Conway, Gerard S.
中科院分区：
文献类型：
--
作者：
Casteras, Anna;De Silva, Purnami;Conway, Gerard S.
据报道，患有典型先天性肾上腺皮质增生症（CAH）的女性生育率较低;然而，试图怀孕的女性的真实怀孕率尚不清楚。我们的目的是计算CAH妇女的怀孕率，计算为那些试图怀孕的比例。对106例典型CAH妇女进行多学科随访[失盐型（SL）81例，非失盐型（NSL）25例]，25例（23.6%）CAH妇女考虑做母亲，23例积极尝试受孕，21例（91.3%）成功妊娠34次。妊娠率与正常人群（95%）无差异。SL（88.9%）和NSL（92.9%）亚组的妊娠率相似，但NSL-CAH患者比SL-CAH患者更有可能寻求母亲（16/25 vs. 9/81）。在生育监测过程中优化糖皮质激素和盐皮质激素方案导致几乎所有近期病例自发受孕。生育率为每名妇女0.25个活产，而英国人口为1.8个活产（P < 0.001）。我们报道了典型CAH妇女的正常妊娠率（91.3%），SL和NSL亚组相似。然而，生育率仍然远远低于总人口。
Fertility in women with classical congenital adrenal hyperplasia (CAH) has been reported low; however, the true pregnancy rate for women trying to conceive with this condition is unknown. Our aim was to calculate pregnancy rate for women with CAH calculated as a proportion of those who had attempted conception. Fertility expressed as live birth rate is also calculated.One hundred and six women with classical CAH followed in a multidisciplinary service [81 salt-losing (SL) and 25 nonsalt-losing (NSL) form].Twenty-five (23.6%) women with CAH women considered motherhood, 23 had actively tried conception of whom 21 (91.3%) achieved 34 pregnancies. Pregnancy rate is no different from that in the normal population (95%). Pregnancy rates were similar in the SL (88.9%) and NSL (92.9%) subgroups but those with NSL-CAH were more likely to seek motherhood than those with SL-CAH (16/25 vs. 9/81). Optimized glucocorticoid and mineralocorticoid regimes during fertility monitoring resulted spontaneous conception in nearly all recent cases. Fertility rate was 0.25 live births per woman compared with 1.8 in the UK population (P < 0.001).We report a normal pregnancy rate (91.3%) for women with classical CAH, similar in SL and NSL subgroups. Fertility rate, however, remains much lower than in general population.