Q: I have read several articles about the use of Dex during pregnancy to treat a possibly CAH effected fetus. I have not seen any info about best treatment for a mother with CAH during pregnancy when the fetus will not be effected with CAH?

I have had two pregnancies, both were difficult due to a lot of illnesses and infections. When I am on dex these things are better controlled for me, but during pregnancies I switched to prednisone and don’t feel as well controlled.

So I guess my question is what are the real risks of remaining on dex as MY treatment when my child will not have CAH?

A: Because the long-term safety of dexamethasone on a developing fetus has not been well-established, the use of dexamethasone during pregnancy without a specific indication (e.g. prenatal treatment of an affected female) is not recommended. Prednisone has some crossing of the placenta and is not our preferred treatment. Hydrocortisone does not cross the placental barrier and is considered the safest treatment during pregnancy for mothers who require treatment for their own medical condition.