Libby G Lord, Anthony G B Walters, Caroline A Crowther, Stuart R Dalziel, Carl L Eagleton, Greg D Gamble, Jane E Harding, Christopher J D McKinlay, Barry J Milne, Robyn W May
{"title":"Second generation effects of antenatal corticosteroid exposure: 50-year follow-up of the Auckland Steroid Trial.","authors":"Libby G Lord, Anthony G B Walters, Caroline A Crowther, Stuart R Dalziel, Carl L Eagleton, Greg D Gamble, Jane E Harding, Christopher J D McKinlay, Barry J Milne, Robyn W May","doi":"10.1017/S204017442510007X","DOIUrl":"10.1017/S204017442510007X","url":null,"abstract":"<p><p>Antenatal corticosteroids are given to pregnant people at risk of preterm birth to reduce newborn morbidity, including respiratory distress syndrome. However, there has been concern surrounding potential adverse effects on subsequent generations. Animal studies have demonstrated endocrine and metabolic changes in those exposed to corticosteroids in utero (<i>F</i><sub>1</sub>) and in the second generation (<i>F</i><sub>2</sub>). We aimed to assess the effects of parental antenatal corticosteroid exposure on health of the second generation (<i>F</i><sub>2</sub>) of Auckland Steroid Trial (AST) participants. In the AST, women (<i>F</i><sub>0</sub>) expected to birth between 24 and 36 weeks' gestation were randomised to betamethasone or placebo. When their children (<i>F</i><sub>1</sub>) were 50 years old, they and their children (<i>F</i><sub>2</sub>) were followed up with a self-report questionnaire and data linkage. The primary outcome for this analysis was body mass index (BMI) z-score in the <i>F</i><sub>2</sub> generation. Secondary outcomes included respiratory, cardiovascular, neurodevelopmental, mental and general health, and social outcomes. Of the 213 <i>F</i><sub>2</sub> participants, 144 had BMI data available. There was no difference in BMI z-score between participants whose parent was exposed to betamethasone versus placebo (mean (<i>SD</i>) 0.63 (1.45), <i>N</i> = 77 vs 0.41 (1.28), <i>N</i> = 67, adjusted mean difference (95% confidence interval) = 0.16 (-0.37, 0.69)). There was no evidence of a difference in rates of overweight, diabetes, respiratory disease, cardiometabolic risk factors, neurodevelopmental difficulties, mental health difficulties and social outcomes between parental betamethasone versus placebo exposure groups, but confidence intervals were wide. These findings are reassuring regarding the intergenerational safety of antenatal corticosteroids.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e25"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Restricted fetal blood brain barrier permeability in a preclinical model of autism induced by Group B <i>Streptococcus</i> maternal immune activation.","authors":"Margaux Digonnet, Mathilde Chevin, Nadia Alfaidy, Tiphaine Raia-Barjat, Antoine Giraud, Guillaume Sébire","doi":"10.1017/S2040174425100147","DOIUrl":"https://doi.org/10.1017/S2040174425100147","url":null,"abstract":"<p><p>Clinical and preclinical data about perinatal inflammation show its implication in brain injuries leading to autism spectrum disorder (ASD). For instance, Group B <i>Streptococcus</i> (GBS) chorioamnionitis generates autistic manifestations in the progeny. However, the precise way(s) how chorioamnionitis exerts its noxious effect on the central nervous system remains to be define. The pathogen-induced inflammatory response effects on the permeability of the blood brain barrier (BBB) have been documented in the mature brain. No study deals with the effect of GBS-induced chorioamnionitis, on the fetal BBB, even though it is one of the most common infection affecting the fetal environment. Given that dysfunctions of several key cells and molecules from the BBB seem to be involved in the pathogenesis of ASD from genetic and/or environmental origins, we hypothesized that pathogen-induced chorioamnionitis affects structurally and functionally the BBB. We used a well-established preclinical model of GBS chorioamnionitis leading to ASD phenotype in male offspring. We document a significant decrease of albumin permeability of the BBB in the white and gray matters of fetuses exposed <i>versus</i> unexposed to GBS chorioamnionitis. In line with this result, a significant increase in the expression of claudin-5 - component of tight junctions of the BBB - is detected in endothelial cells from BBB exposed to chorioamnionitis. Altogether, our results show that beyond genetic determinants, environmental factors such as bacterial infections affect the integrity of the BBB and might be involved in the fetal programming of ASD.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e30"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fetal exposures and maternal mental disorders in pregnancy: a network analysis.","authors":"Andrew J Lewis, Brooke Van Zanden, Megan Galbally","doi":"10.1017/S2040174425100093","DOIUrl":"https://doi.org/10.1017/S2040174425100093","url":null,"abstract":"<p><p>Maternal mental health represents a significant global health burden, not only in terms of maternal wellbeing, but also for the impact it has on child development. The relationship between maternal mental health and deleterious environmental exposures to the fetus is one mechanism of risk transmission. This study utilizes network analysis to a) explore how maternal mental health is associated with a wide array of fetal exposures, and b) examine how these exposures cluster together. A total of 485 pregnant women were recruited from the Mercy Hospital for Women in Melbourne, Australia between 2011-2017, as part of the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). The MPEWS includes measures of mental health diagnosis and symptoms, psychotropic medication, smoking, alcohol, substance use, and a wide range of lifestyle factors in the first and third trimesters of pregnancy. Regularized Partial Correlation Modelling was used to examine the network of relationships between maternal mental health and fetal exposures due to environmental factors, lifestyle and medications. For women diagnosed with mental health disorders there are relatively higher rates of exposure to smoking, anxiety and depression symptoms, psychotropic medications, pregnancy health conditions and less than optimal lifestyle factors. Factors such as physical exercise and folate supplementation show strong patterns of partial correlation. Trait anxiety emerged as the central variable in the network with the highest strength of relationship to all other exposure variables. The current study shows the value of approaching fetal exposures as a complex network of associated aspects of maternal lifestyle, mental health and environment. Viewing exposures together may assist clinical and public health interventions to target multiple associated risk factors, rather than the current focus on individual exposures. The preconception and perinatal periods offer important opportunities for the prevention of teratogenic fetal exposures and the promotion of a healthy start to life.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e27"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Audrey J Craner, Carl R Dahlen, Jennifer L Hurlbert, Ana Clara B Menezes, Priyanka Banerjee, Friederike Baumgaertner, Kerri A Bochantin-Winders, Samat Amat, Kevin K Sedivec, Kendall C Swanson, Wellison J S Diniz
{"title":"Early life programming of the neonatal bovine jejunum in response to maternal vitamin and mineral supplementation.","authors":"Audrey J Craner, Carl R Dahlen, Jennifer L Hurlbert, Ana Clara B Menezes, Priyanka Banerjee, Friederike Baumgaertner, Kerri A Bochantin-Winders, Samat Amat, Kevin K Sedivec, Kendall C Swanson, Wellison J S Diniz","doi":"10.1017/S2040174425000157","DOIUrl":"https://doi.org/10.1017/S2040174425000157","url":null,"abstract":"<p><p>We investigated the effects of maternal vitamin and mineral supplementation throughout gestation on gene expression in the jejunal mucosa of neonatal calves. Crossbred Angus heifers (<i>n</i> = 14) were estrus synchronized, bred to female-sexed semen, and randomly assigned to a basal diet (Control, CON; <i>n</i> = 7) or the basal diet plus vitamin and mineral supplement (Treatment, VTM; <i>n</i> = 7). After parturition, calves were removed from their dams before suckling, fed colostrum replacer, and euthanized 30 h after the first feeding. A subsample of the mucosa of the mid-jejunum was collected, and total RNA was isolated. Gene expression was measured using RNA-Seq, and differentially expressed genes (DEGs) were identified using DESeq2. We identified 528 DEGs from the jejunal mucosa between the VTM and CON calves (<i>P</i> ≤ 0.05 and |log2FC| ≥ 0.5). The DEGs were associated with nutrient transport, lipid metabolism, and immune-related biological processes and pathways. Interestingly, genes underlying the complement and coagulation cascades were mostly downregulated in calves born to VTM dams. On the other hand, the cytokine-cytokine receptor interaction KEGG pathway showed most genes upregulated (<i>LIFR, KDR, TNFRSF4, TNFSF18, FLT1,</i> and <i>TNFRSF12A</i>). Our results show that vitamin and mineral supplementation throughout gestation affects genes underlying tissue structure, nutrient transport and metabolism, and immune system pathways in neonates. The implications of such changes and the long-term outcomes on herd health and performance warrant further research.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e24"},"PeriodicalIF":1.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Public awareness and understanding of DOHaD concepts in Aotearoa New Zealand.","authors":"J R Hildreth, J L Bay","doi":"10.1017/S2040174425000145","DOIUrl":"10.1017/S2040174425000145","url":null,"abstract":"<p><p>Recent reports suggest that New Zealanders underestimate the burden of non-communicable diseases (NCDs) on society, perceiving NCDs as standalone problems to be managed by affected individuals. This belief conflicts with the Developmental Origins of Health and Disease (DOHaD) hypothesis that NCD risk is rooted in early-life environmental exposures. For the research community to contribute towards shifting societal beliefs, we need to know more about NZers' understanding of how NCDs develop and have the potential to track this over time. To address this, we conducted a face-to-face survey of 702 Auckland adults in 2015-16, repeated in 2022-23 with 814 online and 96 face-to-face respondents. An increased recognition of links between mental health and obesity was the only change observed between the earlier and later cohorts. Overall, of the 59% familiar with the term 'non-communicable disease', 73% accurately described NCD characteristics and gave examples. Online, tertiary-educated and non-male respondents were more likely to identify various social determinants of health in addition to individual behaviours as contributors to metabolic disease risk. More than twice as many subjects strongly agreed that preconception health of mothers could affect the health of the child than that of fathers. Maternal nutrition was recognised by most as important for fetal health, but 49% disagreed or did not know if it could affect adult health. These results indicate that regardless of subject sampling or data collection method, adult New Zealanders have little appreciation of the significance of the early-life environment in relation to NCD risk across the lifespan.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e23"},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priya Vakil, Megan L Gow, Lynne M Roberts, Susan Woolfenden, Valsamma Eapen, Gregory K Davis, Clare Rowe, Maria E Craig, Amanda Henry
{"title":"Infant psychomotor development after intrauterine exposure to hypertensive disorders of pregnancy: a P4 study.","authors":"Priya Vakil, Megan L Gow, Lynne M Roberts, Susan Woolfenden, Valsamma Eapen, Gregory K Davis, Clare Rowe, Maria E Craig, Amanda Henry","doi":"10.1017/S2040174425000121","DOIUrl":"https://doi.org/10.1017/S2040174425000121","url":null,"abstract":"<p><p>This study aimed to assess the impact of hypertensive disorders of pregnancy on infant neurodevelopment by comparing 6-month and 2-year psychomotor development outcomes of infants exposed to gestational hypertension (GH) or preeclampsia (PE) versus normotensive pregnancy (NTP). Participating infants were children of women enrolled in the Postpartum Physiology, Psychology and Paediatric (P4) cohort study who had NTPs, GH or PE. 6-month and 2-year Ages and Stages Questionnaires (ASQ-3) scores were categorised as passes or fails according to domain-specific values. For the 2-year Bayley Scales of Infant and Toddler Development (BSID-III) assessment, scores > 2 standard deviations below the mean in a domain were defined as developmental delay. Infants (<i>n</i> = 369, male = 190) exposed to PE (<i>n</i> = 75) versus GH (<i>n</i> = 20) and NTP (<i>n</i> = 274) were more likely to be born small for gestational age and premature. After adjustment, at 2 years, prematurity status was significantly associated with failing any domain of the ASQ-3 (<i>p</i> = 0.015), and maternal tertiary education with increased cognitive scores on the BSID-III (<i>p</i> = 0.013). However, PE and GH exposure were not associated with clinically significant risks of delayed infant neurodevelopment in this study. Larger, multicentre studies are required to further clarify early childhood neurodevelopmental outcomes following hypertensive pregnancies.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e22"},"PeriodicalIF":1.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael R Hussey, James MacDonald, Theo K Bammler, Fasil Tekola-Ayele, Kathleen F Kerr, Alison G Paquette, Carmen J Marsit, Kaja Z LeWinn, Qi Zhao, Catherine J Karr, Sheela Sathyanarayana, Daniel A Enquobahrie
{"title":"Associations of placental lncRNA expression with maternal pre-pregnancy BMI and infant birthweight in two birth cohorts.","authors":"Michael R Hussey, James MacDonald, Theo K Bammler, Fasil Tekola-Ayele, Kathleen F Kerr, Alison G Paquette, Carmen J Marsit, Kaja Z LeWinn, Qi Zhao, Catherine J Karr, Sheela Sathyanarayana, Daniel A Enquobahrie","doi":"10.1017/S204017442500011X","DOIUrl":"10.1017/S204017442500011X","url":null,"abstract":"<p><p>Pre-pregnancy obesity (ppOB) is linked to pregnancy complications and abnormal fetal growth through placental mechanisms, and long non-coding RNAs (lncRNAs) may play an epigenetic role in these processes. We investigated overall and sex-specific associations of pre-pregnancy body mass index (ppBMI), ppOB, and birthweight with placental lncRNA transcripts in two birth cohorts. Study participants were mother-child dyads recruited to the CANDLE (Memphis, TN)(<i>n</i> = 725) and GAPPS (Seattle and Yakima, WA)(<i>n</i> = 159) cohorts. Maternal ppBMI was assessed at enrollment using interviewer-administered questionnaires. LncRNAs (1,077 and 1,033 for CANDLE and GAPPS, respectively) were sequenced from placental samples collected at birth. Placental lncRNA was regressed on ppBMI, ppOB (ppBMI ≥30kg/m<sup>2</sup>), or continuous birthweight in cohort-specific weighted linear models controlling for <i>a priori</i>-specified confounders and experimental variables. Potential effect modification by infant-sex was examined in sex-stratified analyses and models including BMI-infant-sex interaction terms. No lncRNA transcripts were significantly associated with ppBMI, ppOB, or birthweight in primary models. Among male infants in CANDLE, expression of three lncRNA transcripts (<i>ERVH48-1</i>, <i>AC139099.1</i>, <i>CEBPA-DT</i>) was associated with ppBMI and one transcript (<i>AC104083.1</i>) with birthweight. In GAPPS, ppBMI was associated with two lncRNA transcripts (<i>AP000879.1</i> and <i>AL365203.2</i>) among males, and birthweight was associated with 17 lncRNA transcripts (including <i>LINC02709</i>, <i>KANSL1-AS1, DANCR, EPB41L4A-AS1</i>, and <i>GABPB1-AS1</i>) among females. No BMI-infant-sex interactions were observed. Though many of these potential associations are for uncharacterized transcripts, several identified lncRNAs (e.g., <i>ERVH48-1</i> and <i>CEBPA-DT</i>) have been linked to pathways controlling cancer or placental growth, trophoblast differentiation, and gene expression. These associations warrant validation in future studies.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e20"},"PeriodicalIF":1.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cyrielle Holuka, Alessia Melacca, Giorgia Menta, Conchita D'Ambrosio, Sandra Morano, Jasminka Štefulj, Jean Calleja-Agius, Laura Bordoni, Rosita Gabbianelli, Jonathan D Turner
{"title":"Maternal birth experience and DNA methylation.","authors":"Cyrielle Holuka, Alessia Melacca, Giorgia Menta, Conchita D'Ambrosio, Sandra Morano, Jasminka Štefulj, Jean Calleja-Agius, Laura Bordoni, Rosita Gabbianelli, Jonathan D Turner","doi":"10.1017/S2040174425000133","DOIUrl":"10.1017/S2040174425000133","url":null,"abstract":"<p><p>Childbirth influences maternal and new-born's future health, with the Epigenetic Impact of Childbirth (EPIIC) hypothesis proposing that labour stress affects foetal gene expression. This study explores how birth experiences relate to DNA methylation in infants, breastfeeding and mother-infant bonding. Data from the Avon Longitudinal Study of Parents and Children was used, including 14,541 pregnant women. The ARIES subset of 1,022 mother-child pairs provided DNA methylation profiles. Maternal birth experience (MBE) was evaluated, with mother-infant bonding and breastfeeding. Statistical analysis involved linear regression and epigenome-wide association study. Half of the mothers reported at least one negative childbirth event, with 7% experiencing three or more adverse events. Negative MBE correlated with shorter breastfeeding duration and weaker mother-infant bonding. No significant CpG associations with MBE were found. While positive MBE is linked to improved mother-infant bonding and breastfeeding, no significant changes in DNA methylation profiles were observed in the offspring. Further research is needed to understand MBE's long-term impact on child health.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e21"},"PeriodicalIF":1.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard Meitern, Markus Valge, Velda Lauringson, Peeter Hõrak
{"title":"Birth season associates with multiple anthropometric traits in Estonian children.","authors":"Richard Meitern, Markus Valge, Velda Lauringson, Peeter Hõrak","doi":"10.1017/S2040174425000108","DOIUrl":"https://doi.org/10.1017/S2040174425000108","url":null,"abstract":"<p><p>Seasonal variation in maternal exposure to sunlight during pregnancy, which relates to variation in vitamin D and other micronutrient availability for a fetus, is a prevalent explanation for the variation of offspring traits with birth season. However, little consensus exists about the pregnancy period during which the fetus is most sensitive to maternal UV exposure and which offspring traits are most sensitive. We examined the association between 11 anthropometric traits and birth season/month among 18,459-23,876 Estonian children born in 1937-62. Nine traits showed seasonal patterns, which were generally weak, compared to the effects of family socioeconomic position (SEP). Most prominent nonlinear associations between offspring traits and birth month emerged among children of mothers in unskilled manual professions. A possible explanation is that the growth of children in high-SEP families is more strongly buffered against any external exposures (including possible shortage of maternally synthesised vitamin D and essential micronutrient availability) than in low-SEP settings. For most traits, children born in spring/summer were larger than those born in autumn/winter. Hip width, trunk length and weight showed the most distinct seasonal patterns. If these birth-season-related patterns are related to maternal sunlight exposure, our results support the view that UV exposure benefits offspring growth towards the end of pregnancy. It is also possible that children born in spring and summer benefitted from the seasonally increasing nutrient availability during the first post-natal months.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e19"},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A review of the potential off-target effects of antenatal steroid exposures on fetal development.","authors":"Sean W D Carter, Matthew W Kemp","doi":"10.1017/S2040174425000078","DOIUrl":"10.1017/S2040174425000078","url":null,"abstract":"<p><p>Antenatal steroids (ANS) are one of the most widely prescribed medications in pregnancy, being administered to women at risk of preterm delivery. In the setting of preterm delivery at or below 35 weeks' gestation, systematic review data show ANS reduce perinatal morbidity and mortality, primarily by promoting fetal lung maturation. However, with the expanding use of this intervention has come a growing appreciation for the potential off-target, adverse effects of ANS therapy on wider fetal development. We undertook a narrative literature review of the animal and clinical literature to assess current evidence for adverse effects of ANS exposure and fetal development. This review presents a summary of the evidence relating to the potential for wide-ranging, off-target, adverse effects of ANS therapy on fetal development and programming. We highlight an urgent need for further animal and clinical studies investigating the effects of ANS on the fetal immune, cardiovascular, renal and hepatic systems given a current sparsity of evidence. We also strongly suggest an emphasis on open disclosure, discussion and education of clinicians and patients with regard to the potential benefits and risks of ANS therapy, particularly in late preterm and term gestations where infants derive relatively few benefits from these drugs. We also propose further studies on the optimisation of ANS therapy through improved patient selection and improved dosing regimens based on a pharmacokinetic-pharmacodynamic informed understanding of ANS action on the fetal lung.</p>","PeriodicalId":49167,"journal":{"name":"Journal of Developmental Origins of Health and Disease","volume":"16 ","pages":"e18"},"PeriodicalIF":1.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}