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Changes over time in sex assignment for disorders of sex development
Z. Kolesinska, SF. Ahmed, M. Niedziela, J. Bryce, M. Molinska-Glura, M. Rodie, J. Jiang, RO. Sinnott, IA. Hughes, F. Darendeliler, O. Hiort, Y. van der Zwan, M. Cools, T. Guran, PM. Holterhus, S. Bertelloni, L. Lisa, W. Arlt, N. Krone, M....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, práce podpořená grantem
PubMed
25092939
DOI
10.1542/peds.2014-1088
Knihovny.cz E-zdroje
- MeSH
- časové faktory MeSH
- dospělí MeSH
- genderová identita * MeSH
- kohortové studie MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- následné studie MeSH
- poruchy sexuálního vývoje diagnóza epidemiologie terapie MeSH
- registrace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
BACKGROUND AND OBJECTIVE: It is unclear whether the proportion of infants with a disorder of sex development who are raised as male or female has changed over time. The temporal trends in sex assignment of affected cases entered in the International Disorder of Sex Development (I-DSD) Registry were studied. METHODS: Cases of disorders of sex development reported as partial androgen insensitivity syndrome (PAIS; n = 118), disorder of gonadal development (DGD; n = 232), and disorder of androgen synthesis (DAS; n = 104) were divided into those who were born before 1990, 1990-1999, and after 1999. External appearance of the genitalia was described by the external masculinization score. RESULTS: The median (5th-95th percentile) external masculinization scores of those infants with PAIS, DGD, and DAS who were raised as boys were 6 (2-9), 6 (3-9), and 6 (1-12), respectively, and were significantly higher than in those raised as girls (2 [0-6], 2 [0-7], and 0 [0-5], respectively); this difference was maintained in the 3 temporal birth cohorts (P < .01). Of the 118 cases in the pre-1990 cohort, 41 (35%) were raised as boys; of the 148 cases in the 1990-1999 cohort, 60 (41%) were raised as boys; and of the 188 cases in the post-1999 cohort, 128 (68%) were raised as boys. CONCLUSIONS: Although there is an association between the external appearance of the genitalia and the choice of sex assignment, there are clear temporal trends in this practice pointing toward an increased likelihood of affected infants being raised as boys. The impact of this change in practice on long-term health outcomes requires additional focus.
Ahfad University for Women Omdurman Sudan
Al Neelain Medical Research Centre Khartoum Sudan
Centre for Endocrinology Diabetes and Metabolism University of Birmingham Birmingham United Kingdom
Institute of Endocrinology Prague Czech Republic
Istanbul University Istanbul Turkey
Karolinska Institutet Stockholm Sweden
Marmara University Istanbul Turkey
National Research Centre Cairo Egypt
Pediatric Endocrinology and Diabetes Unit Dana Children's Hospital Tel Aviv Israel
Poznan University of Medical Sciences Poznan Poland
Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
Sophia Children's Hospital Erasmus MC Rotterdam Netherlands
Sourasky Medical Center Tel Aviv Israel
University Claude Bernard Lyon 1 Lyon France
University Hospital Bologna Bologna Italy
University Hospital Ghent Ghent University Ghent Belgium
University Hospital Pisa Pisa Italy
University Hospital Schleswig Holstein Kiel Germany
University of Cambridge Cambridge United Kingdom
University of Glasgow Glasgow United Kingdom
University of Lübeck Lübeck Germany
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- $a BACKGROUND AND OBJECTIVE: It is unclear whether the proportion of infants with a disorder of sex development who are raised as male or female has changed over time. The temporal trends in sex assignment of affected cases entered in the International Disorder of Sex Development (I-DSD) Registry were studied. METHODS: Cases of disorders of sex development reported as partial androgen insensitivity syndrome (PAIS; n = 118), disorder of gonadal development (DGD; n = 232), and disorder of androgen synthesis (DAS; n = 104) were divided into those who were born before 1990, 1990-1999, and after 1999. External appearance of the genitalia was described by the external masculinization score. RESULTS: The median (5th-95th percentile) external masculinization scores of those infants with PAIS, DGD, and DAS who were raised as boys were 6 (2-9), 6 (3-9), and 6 (1-12), respectively, and were significantly higher than in those raised as girls (2 [0-6], 2 [0-7], and 0 [0-5], respectively); this difference was maintained in the 3 temporal birth cohorts (P < .01). Of the 118 cases in the pre-1990 cohort, 41 (35%) were raised as boys; of the 148 cases in the 1990-1999 cohort, 60 (41%) were raised as boys; and of the 188 cases in the post-1999 cohort, 128 (68%) were raised as boys. CONCLUSIONS: Although there is an association between the external appearance of the genitalia and the choice of sex assignment, there are clear temporal trends in this practice pointing toward an increased likelihood of affected infants being raised as boys. The impact of this change in practice on long-term health outcomes requires additional focus.
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- $a Chatelain, Pierre $u University Claude Bernard Lyon 1, Lyon, France;
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- $a Weintrob, Naomi $u Pediatric Endocrinology and Diabetes Unit, Dana Children's Hospital, Tel Aviv, Israel; Sourasky Medical Center, Tel Aviv, Israel; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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