Context: Normal to decreased final height (FH) has been reported in patients with congenital adrenal hyperplasia (CAH).

Objective: To determine FH outcome and influences of steroid treatment.

Methods: The effects of glucocorticoid treatment for classical CAH were retrospectively studied in 125 patients (77 females). Growth pattern, FH and pubertal development were recorded.

Results: Corrected FH (corr FH) was in the lower range of genetic potential (females with SV-CAH -0.6±1.0 SDS vs. females with SW-CAH -0.6±0.9 SDS, males with SV-CAH -1.1±0.9 SDS vs. males with SW-CAH -0.9±0.9 SDS). Total pubertal growth was significantly reduced in comparison to a reference population (females with SV-CAH 11.9±6.5 cm and females with SW-CAH 13.8±7.6 cm vs. reference 20.3±6.8 cm, p<0.01, and males with SV-CAH 15.4±6.6 cm and males with SW-CAH 18.5±6.9 cm vs. reference 28.2±8.2 cm, p<0.01).

33 patients had been treated with prednisone, which resulted in reduced FH compared to patients (n=92) treated with hydrocortisone (-1.0±0.9 SDS vs. -0.6±0.9 SDS, p<0.05). FH correlated negatively with hydrocortisone dose given at start of puberty (r=-0.3, p<0.05). Pubertal development started early in boys (9.8±2.3 years [SV] and 10.6±1.9 years [SW]), and timely in girls (9.8±1.9 years [SV] and 10.3±1.5 years [SW], menarche at 13.3±1.7 years [SV] and 13.7±1.5 years [SV]).

Conclusion: Patients with CAH are able to achieve adequate final height with conventional therapy. Total pubertal growth is significantly decreased and treatment with prednisone results in decreased FH. In addition to biochemical analysis treatment should be adjusted to normal growth velocity, especially during puberty.