Developmental toxicity and programming alterations of multiple organs in offspring induced by medication during pregnancy

Acta Pharm Sin B. 2023 Feb;13(2):460-477. doi: 10.1016/j.apsb.2022.05.029. Epub 2022 Jun 3.

Abstract

Medication during pregnancy is widespread, but there are few reports on its fetal safety. Recent studies suggest that medication during pregnancy can affect fetal morphological and functional development through multiple pathways, multiple organs, and multiple targets. Its mechanisms involve direct ways such as oxidative stress, epigenetic modification, and metabolic activation, and it may also be indirectly caused by placental dysfunction. Further studies have found that medication during pregnancy may also indirectly lead to multi-organ developmental programming, functional homeostasis changes, and susceptibility to related diseases in offspring by inducing fetal intrauterine exposure to too high or too low levels of maternal-derived glucocorticoids. The organ developmental toxicity and programming alterations caused by medication during pregnancy may also have gender differences and multi-generational genetic effects mediated by abnormal epigenetic modification. Combined with the latest research results of our laboratory, this paper reviews the latest research progress on the developmental toxicity and functional programming alterations of multiple organs in offspring induced by medication during pregnancy, which can provide a theoretical and experimental basis for rational medication during pregnancy and effective prevention and treatment of drug-related multiple fetal-originated diseases.

Keywords: Developmental programming; Developmental toxicity; Gender differences; Maternal-derived glucocorticoids; Medication; Multi-generational genetic effects; Multiple organs; Pregnancy.

Publication types

  • Review