Key Points
2
➤ All newborn screening programs should incorporate screening for
congenital adrenal hyperplasia, and infants with positive screens should
be referred to pediatric endocrinologists.
➤ Prenatal therapy for congenital adrenal hyperplasia should be avoided
(except as part of ethically-approved protocols) due to incompletely
defined postnatal risks.
➤ Healthcare professionals should inform all parents of pediatric patients
with CAH (particularly girls with ambiguous genitalia) about surgical
options, including delaying surgery until the child is older.
➤ All surgical decisions for minors should be the prerogative of families
(i.e., parents with assent from older children) in joint decision making with
experienced surgical consultants.
➤ Adolescents with congenital adrenal hyperplasia should start the transition
to adult care several years prior to dismissal from pediatric endocrinology
to ensure continuation of care throughout their entire life.
➤ Growing individuals with classic congenital adrenal hyperplasia should
receive maintenance therapy with hydrocortisone and should avoid chronic
use of more potent or long-acting glucocorticoids, which can have adverse
side effects.
➤ Patients with congenital adrenal hyperplasia (and parents of minors)
should seek mental health treatment to address any congenital adrenal
hyperplasia-related psychosocial problems.
