The guidelines will recommend that prenatal treatment of CAH continue to be regarded as an experimental procedure, noting that dexamethasone therapy can cause low birth weight and birth defects, such as cleft palate. The guidelines will be endorsed by the American Academy of Pediatrics, the Lawson Wilkins Pediatric Endocrine Society, the European Society for Paediatric Endocrinology, the European Society of Endocrinology, the Society for Pediatric Urology, the Androgen Excess and PCOS Society, and the CARES Foundation.
The guidelines are not concerned with aspects of sexuality, according to Dr. Phyllis Speiser, who helped draft the document.
"Our main concern is long-term safety to the fetus. There are some trials that have been conducted in animal models that have some potential for long-term consequences," said Speiser, who is chief of pediatric endocrinology at Steven and Alexandra Cohen Children's Medical Center of New York and professor of pediatrics at New York University School of Medicine.
Besides an increased risk of cleft palate, those health concerns include a slight reduction in birth weight, she said.
"Our objective really is to be able to gather more information so we make sure that we can properly inform the families. Right now it's difficult to say what all the long-term safety concerns might be," Speiser said, adding that the controversy regarding homosexuality was not a factor in the drafting of the new guidelines.
"That's really not in the list of concerns that we have. That's not an objective of this therapy -- it never has been. I don't think that's really on the table here for consideration," Speiser said. "Unfortunately, doctors' intentions may have been misinterpreted."
But Dreger and her colleagues remain concerned that medical attempts to prevent homosexuality in utero will arise if researchers determine that sexual orientation is an innate quality of human biology.
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