In utero beta 2 adrenergic agonist exposure and adverse neurophysiologic and behavioral outcomes.
Beta 2 adrenergic receptor overstimulation during critical periods of prenatal development can induce a permanent shift in the balance of sympathetic-to-parasympathetic tone. This is a biologically plausible mechanism whereby beta 2 adrenergic agonists can induce functional and behavioral teratogenesis, which explains their association with increases in autism spectrum disorders, psychiatric disorders, poor cognitive, motor function and school performance, and changes in blood pressure in the offspring. The use of beta 2 adrenergic agonists should be limited to proven indications when alternate drugs are ineffective or unavailable; the risks of untreated disease to the mother and fetus are greater than the risk of the beta 2 adrenergic agonist.
Witter
Frank R
FR
Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Zimmerman
Andrew W
AW
Reichmann
James P
JP
Connors
Susan L
SL
D000014:Abnormalities, Drug-Induced / Q000209:etiology* / Q000235:genetics; D000322:Adrenergic Agonists / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists; D001249:Asthma / Q000188:drug therapy; D001794:Blood Pressure / Q000187:drug effects; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005316:Fetal Distress / Q000188:drug therapy; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D001523:Mental Disorders / Q000139:chemically induced; D009069:Movement Disorders / Q000151:congenital* / Q000209:etiology; D007752:Obstetric Labor, Premature / Q000188:drug therapy; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000235:genetics; D015149:Tocolytic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use
D000322:Adrenergic Agonists; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D015149:Tocolytic Agents