Fetal HPA activation, preterm birth and postnatal programming
Bibliographic record
Abstract
Activation of the fetal hypothalamic—pituitary—adrenal (HPA) axis in late gestation is a common characteristic across species resulting in increased output of fetal glucocorticoids, contributing to mechanisms associated with the onset of parturition and maturation of organ systems required for extrauterine survival. The fetus responds to an adverse intrauterine environment with precocious HPA activation, and premature upregulation of critical genes at each level along the axis. Thus in utero the fetus may be exposed inappropriately to sustained elevations of glucocorticoids. In addition, fetal glucocorticoid concentrations may be elevated in circumstances of maternal stress, particularly in association with diminished activity of placental 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) activity, or after maternal administration of synthetic glucocorticoids. Animal studies have demonstrated that glucocorticoid administration in late gestation results in intrauterine growth restriction (IUGR) and significant alterations in metabolic and HPA axis function and regulation. These associations among elevated fetal glucocorticoid concentrations and growth and development may underlie the increased incidence of spontaneous preterm labor in small-for-gestational-age babies. They possibly contribute to mechanisms by which aberrant development in utero predisposes to different pathophysiologies in later life. Over the last 10–15 years epidemiological studies have shown that a suboptimal intrauterine environment is associated with an increased risk of developing cardiovascular disease, hypertension, type 2 diabetes and ‘syndrome X’ (metabolic syndrome).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".