In this study, the authors test their hypothesis that excess fetal exposure to glucocorticoid programs increases relative adiposity and central adiposity. They examined associations of plasma levels of corticotropin-releasing hormone (CRH) in the late second trimester of pregnancy, a marker of fetal exposure to glucocorticoids, with child adiposity at the age of three years. Data were gathered from 199 participants in Project Viva, a prospective cohort study of pregnant women and their children. The study used maternal second trimester CRH levels as a reasonable proxy for fetal glucocorticoid exposure, as no current technique allows direct assessment of fetal glucocorticoid exposure in humans.
Findings suggest that increased fetal exposure to glucocorticoids leads to a reduction in body size and perhaps also in overall adiposity, but an increase in central distribution of fat. These results from a general population sample of humans are in accord with several animal experiments. Strengths of this study include a well-characterized prospective cohort with adequate control for a large set of both maternal and child potentially confounding variables. Limitations include a relatively small sample size and restriction of the analytic sample to African Americans and Caucasians only. Further research is warranted to determine the extent to which fetal exposure to glucocorticoids is associated with components of the metabolic syndrome and to investigate the determinants of maternal CRH levels, including psychosocial stress.