Glucocorticoids in pregnancy: A master-switch for fetal maturation - PubMed
2 hours ago
- #fetal development
- #glucocorticoids
- #preterm birth
- The prepartum surge in plasma glucocorticoids aids fetal organ maturation, enabling the switch from placental to newborn physiological systems.
- This glucocorticoid surge is evolutionarily conserved across mammals, though the triggering mechanisms vary among species.
- Premature birth interrupts this natural surge, increasing morbidity and mortality risks, especially due to lung immaturity leading to respiratory diseases.
- Antenatal corticosteroids (ACS) are administered to mimic the missed glucocorticoid signal, enhancing neonatal survival and respiratory outcomes in preterm births.
- Clinical ACS guidelines differ regarding regimens, gestational age limits, and use in cases with existing maternal health conditions.
- Preterm infants show varied ACS responsiveness, with factors like male fetal sex and fetal growth restriction potentially reducing effectiveness, though underlying causes are not fully understood.
- Emerging research suggests that differences in glucocorticoid receptor isoforms and pre-treatment cortisol levels may influence variable ACS responses, highlighting the need for personalized treatment approaches.