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In the prenatal space, these advancements have rapidly changed the field of prenatal diagnosis and have garnered enthusiasm toward interventions aimed at correcting specific disease mechanisms in utero to prevent irreversible injury and\/or leverage fetal physiology to increase the effectiveness of these treatments. Although many promising trials are underway, continued efforts to fully elucidate the intricacies of fetal immunology, the fetal blood\u2013brain barrier and precise molecular processes during different stages of development will be paramount to continued refinement of in utero therapies. The social and ethical implications of fetal therapy are also of utmost importance, especially in an era of increasing restrictions on reproductive autonomy. This review aims to summarize current efforts toward in utero targeted fetal therapies as well as the history and ethical implications of such endeavors.<\/jats:p>","DOI":"10.1002\/ajmg.c.32135","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T17:05:41Z","timestamp":1742835941000},"page":"194-202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["In Utero Therapies, the Next Frontier"],"prefix":"10.1002","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8093-0774","authenticated-orcid":false,"given":"Teodora R.","family":"Kolarova","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology University of Washington  Seattle Washington USA"},{"name":"Division of Medical Genetics, Department of Internal Medicine University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aav8375"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1800352"},{"key":"e_1_2_12_4_1","unstructured":"Boost Pharma Inc.2024.\u201cBoost Pharma Announces Positive Top\u2010Line Results From Phase I\/Ii Boostb4 Study Demonstrating Over 75% Reduction of Fracture Rates in Children Born With Rare Bone Disease Osteogenesis Imperfecta (Oi).\u201dhttps:\/\/boostpharma.com\/wp\u2010content\/uploads\/2024\/09\/BOOST\u2010PR\u2010Clinical\u2010Data\u2010Sept\u20102024.pdf."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010021\u201024443\u20108"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000653"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201801391R"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023349"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymthe.2024.02.004"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2200587"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1970030402"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9062004"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.157229"},{"key":"e_1_2_12_14_1","unstructured":"Evolution of Prenatal Testing.2017.\u201cThe Hastings Center.\u201dhttps:\/\/www.thehastingscenter.org\/prenatal\/evolution\u2010prenatal\u2010testing\/."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/177330a0"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2016.12.005"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000530261"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914\u2010020\u201000594\u20103"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2020.1867932"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6460"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v91i13\u2010S.10534"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2024.06.003"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2022.2030588"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102020\u2010142698"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP274938"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010018\u20100106\u20107"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100033\u20101364191"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aay8980"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2020.11.002"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2400783121"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010018\u20100025\u20104"},{"key":"e_1_2_12_32_1","unstructured":"Protections (OHRP) O. for H. 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