Cognitive outcome in adult women affected by congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
BACKGROUND
Some research suggests that girls with congenital adrenal hyperplasia (CAH), who are exposed to higher than normal levels of prenatal androgens, perform better on spatial tasks, worse on verbal tasks and have a greater incidence of left-handedness than unaffected controls, all of which suggests the development of a more male-typical cognitive pattern. However, research in all three areas has produced inconsistent findings.


OBJECTIVE
To determine if prenatal androgen exposure has an organizing effect on female cognitive development and to what extent.


METHODS
24 women, 21-71 years, with either the salt-losing (SL) or simple virilizing (SV) forms of CAH due to 21-hydroxylase deficiency, and 18 controls, 21-73 years, who were unaffected female relatives or women with polycystic ovary syndrome, were assessed with IQ, handedness, executive function, verbal learning and memory, non-verbal learning and memory, perceptual speed, visuospatial processing and visuomotor ability measures. The battery included tests known to elicit sex differences and control measures.


RESULTS
The findings did not support the hypothesis that women with CAH develop a more male-typical cognitive pattern.


CONCLUSIONS
This study differs from others in the older age of its participants, grouping by SL/SV diagnosis and assessment of medical treatment and compliance as determined through hormone assays. Our findings provide additional support for the conclusion that, in adult women with CAH, previous prenatal androgen exposure does not enhance spatial abilities, impair verbal abilities nor alter hand preferences in a long-lasting way.
Malouf
Matthew A
MA
Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Migeon
Claude J
CJ
Carson
Kathryn A
KA
Petrucci
Loredana
L
Wisniewski
Amy B
AB
D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000523:psychology*; D000328:Adult; D000368:Aged; D000728:Androgens / Q000502:physiology; D000735:Androstenedione / Q000097:blood; D003071:Cognition; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008568:Memory; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D013028:Space Perception; D013255:Steroid 21-Hydroxylase / Q000378:metabolism; D013739:Testosterone / Q000097:blood; D014706:Verbal Learning
D000728:Androgens; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D013255:Steroid 21-Hydroxylase