@article{
author = "Manojlović-Stojanoski, Milica and Ristić, Nataša and Singh, Sandra and Milošević, Verica",
year = "2014",
abstract = "Fetal development is a critical period in the life cycle which is why
the placenta provides a structural and physiological barrier that
protects the fetus from the outer fluctuations and inner disturbances. A
variety of influences from the environment, however, might induce fetal
overexposure to glucocorticoids that target the fetal
hypothalamic-pituitary-adrenal (HPA) axis and influence the fetal growth
trajectory. Development of the HPA axis starts in the early stages of
pregnancy, but the timing of HPA axis maturation and the glucocorticoid
receptor (GR) expression in relation to birth is highly
species-specific. The functional state of the fetal HPA axis plays a key
role in the maturation of many organs necessary for intrauterine
development and existence after birth. A functional HPA axis in
near-term fetuses provides an adequate response to stress and also
affects the timing of parturition. Due to their potent effect on the
maturation of fetal tissues, synthetic glucocorticoids are used in human
pregnancy at risk of preterm delivery. Dexamethasone and betamethasone,
as the ones most commonly used, cross the placental enzymatic barrier
(11 beta-hydroxysteroid dehydrogenase type 2 - 11 beta-HSD2) and have
25-fold higher affinity to the GR than endogenous glucocorticoids,
stimulating many aspects of fetal maturation. Despite the numerous
positive effects, exposure to synthetic glucocorticoids during fetal
development may result in intrauterine growth retardation and fetal
programming of the HPA axis function which is associated with
cardiovascular, metabolic and psychiatric disorders manifested later in
life. Long-term consequences indicate the need for the implementation of
new studies that will provide a better understanding of the link between
glucocorticoid overexposure during fetal development and adverse
outcomes in adulthood.",
journal = "Journal of Medical Biochemistry",
title = "Antenatal treatment with glucocorticoids and the hypotalamic-pituitary-adrenal axis",
number = "4",
volume = "33",
doi = "10.2478/jomb-2014-0038",
pages = "307-316"
}