Prenatal corticosteroid impact on hippocampus: implications for postnatal outcomes.
Prenatal administration of corticosteroids is common in obstetrics to improve the outcome of premature deliveries. Many pregnant women receive multiple corticosteroid courses. Long-term follow-up studies in humans are limited, but those available suggest detrimental effects on the behavior of those children. Animal data also show adverse effects of prenatal corticosteroids mainly in the hippocampus, a structure sensitive to corticosteroid action. Several molecules involved in neuronal survival, seizure susceptibility, and behavior have been identified as possible targets of prenatal corticosteroid effects. These molecules include hippocampal glucocorticoid receptors, brain-derived neurotrophic factor, corticotropin-releasing hormone, and neuropeptide Y. Prenatal corticosteroid treatment permanently reprograms expression of these molecules. The future goals of research in this area include development of specific antagonists of corticosteroid activation pathways that would help differentiate between positive main effects and undesired adverse effects of prenatally administered corticosteroids.
Departments of Neurology and Neuroscience, Albert Einstein College of Medicine, Einstein/Montefiore Epilepsy Management Center, Bronx, NY 10461, USA. velisek@aecom.yu.edu
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D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000494:pharmacology*; D000818:Animals; D019208:Brain-Derived Neurotrophic Factor / Q000378:metabolism; D016923:Cell Death / Q000187:drug effects; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism; D004198:Disease Susceptibility; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006624:Hippocampus / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D009478:Neuropeptide Y / Q000378:metabolism; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D018019:Receptors, Corticotropin-Releasing Hormone / Q000378:metabolism; D012640:Seizures / Q000209:etiology*
D000305:Adrenal Cortex Hormones; D019208:Brain-Derived Neurotrophic Factor; D009478:Neuropeptide Y; D018019:Receptors, Corticotropin-Releasing Hormone; D003346:Corticotropin-Releasing Hormone