{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:20:20Z","timestamp":1784312420502,"version":"3.55.0"},"reference-count":28,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"James A. Ruppe Career Development Award in Endocrinology"},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DK121888"],"award-info":[{"award-number":["K23DK121888"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due to the rarity of the disease and lack of evidence-based recommendations to guide glucocorticoid and mineralocorticoid dosage adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Multicenter survey on current clinical approaches in managing AI during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective anonymized data collection from 19 international centers from 2013 to 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and Patients<\/jats:title>\n                    <jats:p>128 pregnancies in 113 women with different causes of AI: Addison disease (44%), secondary AI (25%), congenital adrenal hyperplasia (25%), and acquired AI due to bilateral adrenalectomy (6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hydrocortisone (HC) was the most commonly used glucocorticoid in 83% (97\/117) of pregnancies. Glucocorticoid dosage was increased at any time during pregnancy in 73\/128 (57%) of cases. In these cases, the difference in the daily dose of HC equivalent between baseline and the third trimester was 8.6 \u00b1 5.4 (range 1-30) mg. Fludrocortisone dosage was increased in fewer cases (7\/54 during the first trimester, 9\/64 during the second trimester, and 9\/62 cases during the third trimester). Overall, an adrenal crisis was reported in 9\/128 (7%) pregnancies. Cesarean section was the most frequent mode of delivery at 58% (69\/118). Fetal complications were reported in 3\/120 (3%) and minor maternal complications in 15\/120 (13%) pregnancies without fatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This survey confirms good maternal and fetal outcome in women with AI managed in specialized endocrine centers. An emphasis on careful endocrine follow-up and repeated patient education is likely to have reduced the risk of adrenal crisis and resulted in positive outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa266","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T02:09:12Z","timestamp":1589854152000},"page":"e2853-e2863","source":"Crossref","is-referenced-by-count":41,"title":["Current Management and Outcome of Pregnancies in Women With Adrenal Insufficiency: Experience from a Multicenter Survey"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3840-7140","authenticated-orcid":false,"given":"Christina","family":"Bothou","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische Ern\u00e4hrung, Universit\u00e4tsspital Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3482-5065","authenticated-orcid":false,"given":"Gurpreet","family":"Anand","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Endokrinologie, Diabetologie und Klinische Ern\u00e4hrung, Universit\u00e4tsspital Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingfeng","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Kienitz","sequence":"additional","affiliation":[{"name":"Endocrinology in Charlottenburg, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khyatisha","family":"Seejore","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, St James\u2019s University Hospital, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Simeoli","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universit\u00e0 Federico II di Napoli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Ebbehoj","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Department of Endocrinology and Diabetes, Aarhus University, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma G","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, St James\u2019s University Hospital, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria","family":"Paragliola","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Universit\u00e0 Cattolica del Sacro Cuore \u2013 Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Ferrigno","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Universit\u00e0 Federico II di Napoli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Badenhoop","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology, Diabetes and Metabolism, University Hospital, Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9193-2860","authenticated-orcid":false,"given":"Sophie","family":"Bensing","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet and Department of Endocrinology, Inflammation and Infection Theme, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Oksnes","sequence":"additional","affiliation":[{"name":"Endocrinology in Charlottenburg, Berlin, Germany"},{"name":"Department of Clinical Science and K.G. 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