Adverse effects of prenatal dexamethasone exposure on fetal development. (June 2022)

• Record Type: Journal Article
• Authors: Wang, Jingwen; Chen, Fei; Zhu, Shiheng; Li, Xinya; Shi, Wenhao; Dai, Zhiqing; Hao, Lanting; Wang, Xinyi
• Is Part Of: Journal of reproductive immunology. Volume 151(2022)
• Publication Date: 2022-06
• Subjects: Prenatal dexamethasone exposure -- Fetus -- Adulthood -- Mechanism -- COVID-19 -- Depression -- Infertility; Reproduction -- Immunological aspects -- Periodicals; Immunology -- Periodicals; Allergy and Immunology -- Periodicals; Reproduction -- Periodicals; Reproduction -- Immunologie -- Périodiques; Immunologie -- Périodiques; Immunology; Reproduction -- Immunological aspects; Periodicals; Electronic journals; Electronic journals; 615.766
• DOI: 10.1016/j.jri.2022.103619
• Languages: English
• ISSNs: 0165-0378

Abstract

Abstract: Dexamethasone has been widely used in clinical practice to promote fetal lung maturity and reduce neonatal respiratory distress syndrome and perinatal mortality. Nevertheless, its administration is a double-edged sword, as a large number of studies have shown that there are obvious disadvantages in pregnant women and fetal development. In this review, we comprehensively retrospect the latest literature on the toxicological effects and mechanisms of dexamethasone on fetal development, in an attempt to provide a valuable basis for further studies and clinical trials in the future. Overall, prenatal dexamethasone exposure could lead to some adverse consequences on fetal organ systems through intrauterine programming based on the results of current animal and human researches. Potential sequelae include osteoarthritis, hypertension, fatty liver, glomerulosclerosis, depression, diabetes and infertility, some of which can pass on to the next generation. It must be noted that the evidence in humans is preliminary and limited by the small sample size. More studies in large-scale populations are needed to confirm if it raises the risk of sequelae in humans. In addition, we strongly support the application of dexamethasone as a pharmaceutical therapy in pregnant women with coronavirus disease 2019 before a better therapy is developed. However, the adverse side effects that may arise also cannot be ignored. Highlights: PDE could lead to some adverse consequences on fetal organ systems through intrauterine programming. Most of the symptoms or sequelae caused by PDE appeared at prepuberty or early stage of adulthood. The possibility of sequelae in humans caused by PDE need to be further investigated, especially in a larger-scale population. We should pay close attention to the condition of fetus exposed to prenatal dexamethasone in the context of the COVID-19 pandemic.