Classical 21-hydroxylase-deficient congenital adrenal hyperplasia (CAH) is generally a rare disease but the worldwide incidence varies among different populations, ranging from 1 in 282 live births in Yupik Eskimos of Alaska, to 1 in 15,800 in Japan, and 1 in 17,098 in Scotland.[2]Merke DP, Auchus RJ. Congenital adrenal hyperplasia due to 21-hydroxylase deficiency. N Engl J Med. 2020 Sep 24;383(13):1248-61.
http://www.ncbi.nlm.nih.gov/pubmed/32966723?tool=bestpractice.com
Non-classical 21-hydroxylase-deficient CAH is more common and affects between 1 in 200 and 1 in 2000.[3]Auer MK, Nordenström A, Lajic S, et al. Congenital adrenal hyperplasia. Lancet. 2023 Jan 21;401(10372):227-44.
http://www.ncbi.nlm.nih.gov/pubmed/36502822?tool=bestpractice.com
The prevalence is highest among Eastern Mediterranean and Southeast Asian populations.[4]Navarro-Zambrana AN, Sheets LR. Ethnic and national differences in congenital adrenal hyperplasia incidence: a systematic review and meta-analysis. Horm Res Paediatr. 2023;96(3):249-58.
https://karger.com/hrp/article/96/3/249/836387/Ethnic-and-National-Differences-in-Congenital
http://www.ncbi.nlm.nih.gov/pubmed/35973409?tool=bestpractice.com
The incidence of CAH is lower in black infants, compared with white, Hispanic, and Asian infants.[5]Pearce M, DeMartino L, McMahon R, et al. Newborn screening for congenital adrenal hyperplasia in New York State. Mol Genet Metab Rep. 2016 Mar 12;7:1-7.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908061
http://www.ncbi.nlm.nih.gov/pubmed/27331001?tool=bestpractice.com
11β-hydroxylase deficiency is a rarer cause of CAH with a prevalence of 5% to 8%, occuring in an estimated 1 in 100,000 live births. The incidence of 11β-hydroxylase deficiency is highest in the Middle East and North Africa.[6]Khattab A, Haider S, Kumar A, et al. Clinical, genetic, and structural basis of congenital adrenal hyperplasia due to 11-beta-hydroxylase deficiency. Proc Natl Acad Sci U S A. 2017 Mar 7;114(10):E1933-40.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347606
http://www.ncbi.nlm.nih.gov/pubmed/28228528?tool=bestpractice.com