Virilization in a female neonate due to increased maternal androgens

Virilization in a female newborn is usually due to congenital adrenal hyperplasia and requires immediate diagnosis and treatment. A full-term female infant born with ambiguous genitalia was admitted for evaluation. We identified Prader stage 2, normal serum testosterone, normal 17-hydroxyprogesterone and normal female karyotyping [46XX]. The mother had virilization during the first trimester and was found to have elevated serum testosterone on the second day of delivery. High maternal serum testosterone levels can result in virilization in a female newborn and we emphasize the need to consider possible underlying maternal pathology in evaluating such cases