Journal
CLINICAL OBSTETRICS AND GYNECOLOGY
Volume 56, Issue 3, Pages 602-609Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/GRF.0b013e31829939f7
Keywords
glucocorticoids; programming; pregnancy; HPA axis; birthweight
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Funding
- Tommys and the British Heart Foundation
- Chief Scientist Office [CZG/2/478, CZB/4/582] Funding Source: researchfish
- The Sir Jules Thorn Charitable Trust [09/01PhD] Funding Source: researchfish
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Fetal glucocorticoid overexposure is a key potential mechanism underlying the link between low birthweight and later life diseases. The fetus is protected from high maternal glucocorticoid levels by the placental enzyme 11-hydroxysteroid dehydrogenase type 2. Antenatal glucocorticoid administration to women at threat of preterm labor, and high endogenous maternal glucocorticoid levels during pregnancy associate with lower birthweight. Long-term consequences for offspring include hypothalamic-pituitary-adrenal axis activation, increased metabolic and cardiovascular disorders, and neurodevelopmental sequelae. Strategies are needed to limit antenatal glucocorticoid use to those most at risk of preterm labor and to identify those most at risk of future disease.
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