title: Adverse maternal exposures, methylation of glucocorticoid-related genes and perinatal outcomes: a systematic review.
abstract: Maternal environmental exposures affect perinatal outcomes through epigenetic placental changes. We examine the literature addressing associations between adverse maternal exposures, perinatal outcomes and methylation of key genes regulating placental cortisol metabolism.
  
  
  
  We searched three databases for studies that examined NR3C1 and HSD11β1/HSD11 β 2 methylation with maternal exposures or perinatal outcomes. Nineteen studies remained after screening. We followed Cochrane's PRISMA reporting guidelines (2009).
  
  
  
  NR3C1 and HSD11 β methylation were associated with adverse infant neurobehavior, stress response, blood pressure and physical development. In utero exposure to maternal stress, nutrition, preeclampsia, smoking and diabetes were associated with altered NR3C1 and HSD11 β methylation.
  
  
  
  NR3C1 and HSD11 β methylation are useful biomarkers of specific environmental stressors associated with important perinatal outcomes that determine pediatric and adult disease risk.
authors.affiliation: Harvard/MGH Center on Genomics, Vulnerable Populations & Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA.|Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Sairaman
authors.initials: S
authors.lastname: Nagarajan
authors.affiliation: Harvard/MGH Center on Genomics, Vulnerable Populations & Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA.|Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Bobak
authors.initials: B
authors.lastname: Seddighzadeh
authors.affiliation: Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baccarelli
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Wise
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.|Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Williams
authors.affiliation: Harvard/MGH Center on Genomics, Vulnerable Populations & Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA, USA.|Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Alexandra E
authors.initials: AE
authors.lastname: Shields
mesh_terms: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1 / Q000235:genetics; D019175:DNA Methylation; D044127:Epigenesis, Genetic; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics / Q000378:metabolism; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects / Q000235:genetics* / Q000378:metabolism; D011965:Receptors, Glucocorticoid / Q000235:genetics; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000235:genetics / Q000378:metabolism; D013315:Stress, Psychological / Q000235:genetics / Q000378:metabolism
chemical_list: C497713:NR3C1 protein, human; D011965:Receptors, Glucocorticoid; D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1; C468386:HSD11B1 protein, human
keywords: biomarker; epigenetic; glucocorticoid; hydroxysteroid 11-beta dehydrogenases; infant; methylation; pediatric; perinatal; smoking; stress