Introduction Growth reflects a complex interaction of genetic, epigenetic, endocrine, and nutritional factors that regulate cell division, differentiation, and function (see Meler et al. for a recent compilation of genetic and epigenetic conditions leading to fetal growth restriction). Various phases of…
Introduction During fetal life, factors associated with maternal, placental, and fetal environments interact to ensure optimal fetal metabolism and growth. However, in 3% to 7% of pregnancies these interactions become suboptimal and growth of the fetus does not align with…
Introduction Since the early 2000s, researchers and clinicians have greatly expanded the knowledge base of drug entry kinetics as they relate to human milk. Most of the physiochemical properties that affect a drug’s transfer into milk are well known and…
Introduction Drug distribution and clearance determine the concentration of drug that will be attained at the site of drug action. Drug targets include cell surface receptors, intracellular receptors, enzymes, transcriptional mechanisms, ion channels, and molecular transport systems. These targets may…
Introduction Pharmacogenetic variants are DNA variants that influence the metabolism and elimination or the action of medications. Research in pharmacogenetics seeks to understand how these variants influence variability in medication response. For the perinatal pharmacologist, genetic variations that affect drug…
Introduction: From a Passive Filter Barrier Concept to an Active Drug Handling Organ When deconstructed to its basic structure, the placenta is an active (“drug handling”) barrier between two separated systems (maternal, fetal) with placental drug disposition driven by differences…
Introduction Pharmacokinetics describes the absorption, distribution, metabolism, and excretion of drugs. The pharmacokinetic parameters of a drug are used to characterize the drug concentrations reached within the body after a dose and the changes in those concentrations over time. Clinical…
Introduction Pharmacology is a science concerned with the interaction of substances (e.g., drugs) with cells, tissues, and organisms. The in vivo efficacy of a drug is guided by two principles of pharmacology, namely pharmacokinetics and pharmacodynamics. Pharmacokinetics deals with the processes…
Acknowledgments We thank the previous authors, Yi-Yung Chen and Thomas Jansson, for their foundational work and expertise in writing the previous version of this chapter, many of the sections and figures which have been preserved in this revision. Introduction Definitions…
Introduction In the late 1980s the late Dr. David J. P. Barker used historical birth records to pioneer the concept that the origins of adult disease could be strongly associated with fetal environmental exposures in pregnancy that resulted in low…