Having just started DEX treatment yesterday, am feeling rather overwhelmed by all the contradictory studies/advice....

Maria New’s response to the study is pasted below (apologies for the formatting) ....again, nothing conclusive...

Adverse Effects Of Prenatal Dexamethasone: The Evidence Is Inconclusive
Hirvikoski et al. (1) conclude that their study indicates [adverse] “long-term effects on verbal working memory and on aspects of self-perception” of prenatal dexamethasone treatment of children at risk for congenital adrenal hyperplasia. While we welcome their follow-up data on cognitive function in this under-researched population, we do not believe that the data justify their conclusions. In the absence of a prospective randomized clinical trial, the best investigative approach to address this issue would be a prospective case-control study involving blinded assessments comparing separately short- and long-term prenatal dexamethasone-treated children to demographically similar untreated children matched for CAH status, taking into account treatment-refusal rates and considering potentially confounding factors unrelated to the patients’ endocrine statuses. The Hirvikoski study, however, did not use blinded assessments, had no CAH-affected controls, and included only three or four children who received long-term treatment. Moreover, their controls came from two different sources and differed from the dexamethasone-treated group in urban-rural background and participation-refusal rates, raising questions regarding sample comparability. In addition, the findings of another recent Scandinavian study (2) on intelligence in CAH children raise the question of whether marginally impaired full-scale IQ in Hirvikoski’s dexamethasone-exposed group reflected effects of CAH itself rather than dexamethasone. Such disease-related effects might account for some of the changes observed in Hirvikoski’s neuropsychological testing. Another problem with Hirvikoski’s observations is that several of the effects, e.g., anxiety, were significant for CAH-unaffected short-term dexamethasone-treated children, but not for the CAH-affected dexamethasone-treated children (although the latter combined the short-term treated CAH boys with the long -term treated CAH girls). This would imply that short-term exposure to dexamethasone during a very early phase of brain differentiation has adverse effects, but long-term exposure does not. This interpretation seems less plausible than that the apparent differences reflect confounding effects from differences between groups in demographic, sex, and/or disease characteristics. It would, therefore, seem premature to make this study the basis for depriving girls with CAH of a prenatal treatment that has very beneficial effects on their genital development, reducing or obviating the need for genital surgery.