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 forevaluation. We identified Praderstage2, normal serum testosterone, normal 17-hydroxyprogesterone and normal female karyotyping (46XX). The mother had virilization dur¬ing 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 viriliza¬tion in a female newborn and we emphasize the need to consider possible underlying maternal pathology in evaluating such cases.