{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:50:51Z","timestamp":1791971451851,"version":"4.3.4"},"reference-count":72,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Respiratory distress syndrome (RDS) remains a major cause of neonatal mortality following premature birth. Antenatal betamethasone is the standard of care to accelerate fetal lung maturation and improve neonatal outcomes; however, current dosing recommendations assume uniform maternal and fetal exposure across pregnancies. Gestational age (GA)\u2010dependent physiological changes and maternal obesity may alter betamethasone disposition and fetal exposure. This study developed a maternal\u2013fetal physiologically based pharmacokinetic (m\u2010f\u2010PBPK) model to quantify the effects of GA and maternal obesity on betamethasone exposure and evaluate current dosing recommendations between 24 and 34\u00a0gestational weeks. The m\u2010f\u2010PBPK model incorporated maternal CYP3A\u2010mediated metabolism, placental passive diffusion and active efflux via P\u2010glycoprotein (P\u2010gp), placental metabolic clearance, GA\u2010dependent physiology, and formulation\u2010specific release rates of betamethasone phosphate and acetate. Model performance was evaluated using maternal and fetal exposure metrics across gestation. At GA 30 weeks in non\u2010obese pregnancies, placental metabolic clearance contributed approximately 17% of maternal clearance, whereas fetal hepatic metabolism accounted for only 2.4%. Maternal obesity decreased maternal and fetal exposure by approximately 9%, while morbid obesity reduced exposure by 23%. Simulated fetal concentrations remained above the proposed pre\u2010clinical\u2010derived surrogate marker of 2 ng\/mL for a median duration of 38\u201040 h in non\u2010obese, 37.5\u201039 h in obese, and 30\u201032 h in morbidly obese populations. This m\u2010f\u2010PBPK model successfully characterized maternal\u2013fetal pharmacokinetics and provides a mechanistic basis for understanding betamethasone fetal exposure across GAs with and without maternal obesity, supporting optimization of antenatal corticosteroid therapy.<\/jats:p>","DOI":"10.1002\/jcph.70308","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:10:44Z","timestamp":1791969044000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanistic Prediction of Maternal, Fetal, and Amniotic Fluid Betamethasone Concentrations to Support Dosing Optimization in Pregnancy"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0513-0822","authenticated-orcid":false,"given":"Alaa","family":"Mahdi","sequence":"first","affiliation":[{"name":"Center for Pharmacometrics and Systems Pharmacology Department of Pharmaceutics College of Pharmacy University of Florida  Orlando FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0725-9237","authenticated-orcid":false,"given":"Khaled","family":"Abduljalil","sequence":"additional","affiliation":[{"name":"Simcyp Division Certara  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7699-2665","authenticated-orcid":false,"given":"Fernanda de Lima","family":"Moreira","sequence":"additional","affiliation":[{"name":"Federal University of Rio de Janeiro  Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7938-573X","authenticated-orcid":false,"given":"Hiral Raju","family":"Mehta","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics and Systems Pharmacology Department of Pharmaceutics College of Pharmacy University of Florida  Orlando FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-6193","authenticated-orcid":false,"given":"Jhohann Richard de Lima","family":"Benzi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy School of Pharmaceutical Sciences University of S\u00e3o Paulo  S\u00e3o Paulo SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra Cristina","family":"Marcolin","sequence":"additional","affiliation":[{"name":"School of Medicine of Ribeir\u00e3o Preto University of S\u00e3o Paulo  Ribeir\u00e3o Preto SP Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4998-1167","authenticated-orcid":false,"given":"Stephan","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics and Systems Pharmacology Department of Pharmaceutics College of Pharmacy University of Florida  Orlando FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4389-058X","authenticated-orcid":false,"given":"Natalia V.","family":"de Moraes","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics and Systems Pharmacology Department of Pharmaceutics College of Pharmacy University of Florida  Orlando FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"e155","DOI":"10.1097\/AOG.0000000000001711","article-title":"Practice Bulletin No. 171: management of preterm labor","volume":"128","year":"2016","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1038\/s41598-025-31626-6","article-title":"Clinical\u2013radiological profile and risk factors for early mortality in preterm neonates with respiratory distress syndrome in Hoima, Western Uganda","volume":"16","author":"Addow AH","year":"2025","journal-title":"Sci Rep"},{"key":"e_1_2_8_4_1","article-title":"Prophylactic versus selective use of surfactant for preventing morbidity and mortality in preterm infants at risk of respiratory distress syndrome","author":"Beijers RJ","year":"2026","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1542\/peds.50.4.515","article-title":"A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants","volume":"50","author":"Liggins GC","year":"1972","journal-title":"Pediatrics"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/ijgo.13836","article-title":"FIGO good practice recommendations on the use of prenatal corticosteroids to improve outcomes and minimize harm in babies born preterm","volume":"155","author":"Norman J","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1002\/pd.5664","article-title":"Controversies in antenatal corticosteroid treatment","volume":"40","author":"Thevathasan I","year":"2020","journal-title":"Prenatal Diagnosis"},{"key":"e_1_2_8_8_1","article-title":"Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth","volume":"12","author":"McGoldrick E","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_9_1","article-title":"Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth","volume":"8","author":"Williams MJ","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s10928-021-09755-y","article-title":"Population pharmacodynamic modeling of intramuscular and oral dexamethasone and betamethasone effects on six biomarkers with circadian complexities in Indian women","volume":"48","author":"Krzyzanski W","year":"2021","journal-title":"J Pharmacokinet Pharmacodyn"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/BF00542353","article-title":"Pharmacokinetics of betamethasone in healthy adults after intravenous administration","volume":"25","author":"Petersen MC","year":"1983","journal-title":"Eur J Clin Pharmacol"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"132.e1","DOI":"10.1016\/j.ajog.2017.11.560","article-title":"Low\u2010dose betamethasone\u2010acetate for fetal lung maturation in preterm sheep","volume":"218","author":"Schmidt AF","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"L628","DOI":"10.1152\/ajplung.00139.2023","article-title":"Respiratory benefit in preterm lambs is progressively lost when the concentration of fetal plasma betamethasone is titrated below two nanograms per milliliter","volume":"325","author":"Fee EL","year":"2023","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"301.e1","DOI":"10.1016\/j.ajog.2018.05.007","article-title":"The efficacy of antenatal steroid therapy is dependent on the duration of low\u2010concentration fetal exposure: evidence from a sheep model of pregnancy","volume":"219","author":"Kemp MW","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajogmf.2019.100077","article-title":"Optimal timing of antenatal corticosteroid administration and preterm neonatal and early childhood outcomes","volume":"2","author":"Battarbee AN","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.xphs.2020.09.013","article-title":"Pregnancy\u2010related hormones increase nifedipine metabolism in human hepatocytes by inducing CYP3A4 expression","volume":"110","author":"Khatri R","year":"2021","journal-title":"J Pharm Sci"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2023.1218703","article-title":"Pregnancy related hormones increase CYP3A mediated buprenorphine metabolism in human hepatocytes: a comparison to CYP3A substrates nifedipine and midazolam","volume":"14","author":"Fashe MM","year":"2023","journal-title":"Front Pharmacol"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1124\/dmd.112.049015","article-title":"Induction of hepatic CYP3A enzymes by pregnancy\u2010related hormones: studies in human hepatocytes and hepatic cell lines","volume":"41","author":"Papageorgiou I","year":"2013","journal-title":"Drug Metab Dispos"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.2165\/11597440-000000000-00000","article-title":"Anatomical, physiological and metabolic changes with gestational age during normal pregnancy: a database for parameters required in physiologically based pharmacokinetic modelling","volume":"51","author":"Abduljalil K","year":"2012","journal-title":"Clin Pharmacokinet"},{"key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/BF00542524","article-title":"Disposition of betamethasone in parturient women after intravenous administration","volume":"25","author":"Petersen MC","year":"1983","journal-title":"Eur J Clin Pharmacol"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1124\/dmd.116.073957","article-title":"Development of a novel maternal\u2010fetal physiologically based pharmacokinetic Model II: verification of the model for passive placental permeability drugs","volume":"45","author":"Zhang Z","year":"2017","journal-title":"Drug Metab Dispos"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1023\/B:PHAM.0000003377.39548.f6","article-title":"Structural determinants of P\u2010glycoprotein\u2010mediated transport of glucocorticoids","volume":"20","author":"Yates CR","year":"2003","journal-title":"Pharm Res"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1002\/psp4.12674","article-title":"Estimating fetal exposure to the P\u2010gp substrates, corticosteroids, by PBPK modeling to inform prevention of neonatal respiratory distress syndrome","volume":"10","author":"Anoshchenko O","year":"2021","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1124\/dmd.121.000538","article-title":"Successful prediction of human fetal exposure to P\u2010glycoprotein substrate drugs using the proteomics\u2010informed relative expression factor approach and PBPK modeling and simulation","volume":"49","author":"Anoshchenko O","year":"2021","journal-title":"Drug Metab Dispos"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1067\/mcp.2002.120250","article-title":"Pharmacokinetics of betamethasone in twin and singleton pregnancy","volume":"71","author":"Ballabh P","year":"2002","journal-title":"Clin Pharmacol Ther"},{"key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1002\/bcp.70035","article-title":"Pharmacokinetics of betamethasone in pre\u2010eclampsia: an in vivo and ex vivo study","volume":"91","author":"Schoenmakers S","year":"2025","journal-title":"Br J Clin Pharmacol"},{"key":"e_1_2_8_27_1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/0002-9378(77)90466-5","article-title":"In vitro metabolism of prednisolone, dexamethasone, betamethasone, and cortisol by the human placenta","volume":"127","author":"Blanford AT","year":"1977","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1172\/JCI108236","article-title":"Glucocorticoid levels in maternal and cord serum after prenatal betamethasone therapy to prevent respiratory distress syndrome","volume":"56","author":"Ballard PL","year":"1975","journal-title":"J Clin Invest"},{"key":"e_1_2_8_29_1","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1002\/cpt.1887","article-title":"Maternal betamethasone for prevention of respiratory distress syndrome in neonates: population pharmacokinetic and pharmacodynamic approach","volume":"108","author":"Foissac F","year":"2020","journal-title":"Clin Pharm Ther"},{"key":"e_1_2_8_30_1","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/BF00563006","article-title":"The placental transfer of betamethasone","volume":"18","author":"Petersen MC","year":"1980","journal-title":"Eur J Clin Pharmacol"},{"key":"e_1_2_8_31_1","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1111\/bcp.15111","article-title":"Enhanced elimination of betamethasone in dichorionic twin pregnancies","volume":"88","author":"Rodrigues G","year":"2022","journal-title":"Brit J Clinical Pharma"},{"key":"e_1_2_8_32_1","first-page":"471","article-title":"Placental transfer and metabolism of betamethasone in human pregnancy","volume":"49","author":"Anderson AB","year":"1977","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_33_1","doi-asserted-by":"crossref","first-page":"228.e1","DOI":"10.1016\/j.ajog.2024.05.012","article-title":"Optimization of the betamethasone and dexamethasone dosing regimen during pregnancy: a combined placenta perfusion and pregnancy physiologically based pharmacokinetic modeling approach","volume":"232","author":"Van Der Heijden JEM","year":"2025","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_34_1","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1007\/s40262-020-00973-0","article-title":"Fetal physiologically based pharmacokinetic models: systems information on fetal cardiac output and its distribution to different organs during development","volume":"60","author":"Abduljalil K","year":"2021","journal-title":"Clin Pharmacokinet"},{"key":"e_1_2_8_35_1","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1002\/cpt.1438","article-title":"Evaluation of maternal drug exposure following the administration of antenatal corticosteroids during late pregnancy using physiologically\u2010based pharmacokinetic modeling","volume":"106","author":"Ke AB","year":"2019","journal-title":"Clin Pharm Ther"},{"key":"e_1_2_8_36_1","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1111\/bcp.15018","article-title":"Physiologically based pharmacokinetic modelling in pregnancy: model reproducibility and external validation","volume":"88","author":"Silva LL","year":"2022","journal-title":"Brit J Clinical Pharma"},{"key":"e_1_2_8_37_1","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1002\/psp4.12899","article-title":"Minimal physiologically\u2010based hybrid model of pharmacokinetics in pregnant women: application to antenatal corticosteroids","volume":"12","author":"Krzyzanski W","year":"2023","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"key":"e_1_2_8_38_1","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1365-2125.1984.tb02480.x","article-title":"Disposition of betamethasone in parturient women after intramuscular administration","volume":"18","author":"Petersen M","year":"1984","journal-title":"Brit J Clinical Pharma"},{"key":"e_1_2_8_39_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/0002-9378(95)90210-4","article-title":"Scientific basis and therapeutic regimens for use of antenatal glucocorticoids","volume":"173","author":"Ballard PL","year":"1995","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_40_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/cts.12724","article-title":"Pharmacokinetics and pharmacodynamics of intramuscular and oral betamethasone and dexamethasone in reproductive age women in India","volume":"13","author":"Jobe AH","year":"2020","journal-title":"Clin Transl Sci"},{"key":"e_1_2_8_41_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1002\/bdd.2510020307","article-title":"Pharmacokinetic evaluation of betameth asone and its water soluble phosphate ester in humans","volume":"2","author":"Loo JCK","year":"1981","journal-title":"Biopharm Drug Disp"},{"key":"e_1_2_8_42_1","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.3390\/pharmaceutics14061162","article-title":"Application of a physiologically based pharmacokinetic model to predict cefazolin and cefuroxime disposition in obese pregnant women undergoing caesarean section","volume":"14","author":"Alrammaal HH","year":"2022","journal-title":"Pharmaceutics"},{"key":"e_1_2_8_43_1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1677\/joe.0.0460379","article-title":"The metabolism of betamethasone","volume":"46","author":"Butler J","year":"1970","journal-title":"J Endocrinol"},{"key":"e_1_2_8_44_1","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1002\/jps.20502","article-title":"Physiologically based pharmacokinetic modelling 2: predicting the tissue distribution of acids, very weak bases, neutrals and zwitterions","volume":"95","author":"Rodgers T","year":"2006","journal-title":"J Pharm Sci"},{"key":"e_1_2_8_45_1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s10928-020-09711-2","article-title":"Prediction of maternal pharmacokinetics using physiologically based pharmacokinetic models: assessing the impact of the longitudinal changes in the activity of CYP1A2, CYP2D6 and CYP3A4 enzymes during pregnancy","volume":"47","author":"Abduljalil K","year":"2020","journal-title":"J Pharmacokinet Pharmacodyn"},{"key":"e_1_2_8_46_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1208\/ps040104","article-title":"Protein binding predictions in infants","volume":"4","author":"McNamara PJ","year":"2002","journal-title":"AAPS Pharm Sci"},{"key":"e_1_2_8_47_1","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.taap.2012.03.008","article-title":"Oral and inhaled corticosteroids: differences in P\u2010glycoprotein (ABCB1) mediated efflux","volume":"260","author":"Crowe A","year":"2012","journal-title":"Toxicol Appl Pharmacol"},{"key":"e_1_2_8_48_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1124\/jpet.103.054841","article-title":"Developmental expression of the major human hepatic CYP3A enzymes","volume":"307","author":"Stevens JC","year":"2003","journal-title":"J Pharmacol Exp Ther"},{"key":"e_1_2_8_49_1","doi-asserted-by":"crossref","first-page":"447.e17","DOI":"10.1016\/j.ajog.2012.02.016","article-title":"The impact of drug metabolizing enzyme polymorphisms on outcomes after antenatal corticosteroid use","volume":"206","author":"Haas DM","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_50_1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S0002-9378(96)80028-7","article-title":"Mathematic modeling of human amniotic fluid dynamics","volume":"175","author":"Mann SE","year":"1996","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_51_1","doi-asserted-by":"crossref","first-page":"e640","DOI":"10.1542\/peds.2011-3379","article-title":"Preterm birth and body composition at term equivalent age: a systematic review and meta\u2010analysis","volume":"130","author":"Johnson MJ","year":"2012","journal-title":"Pediatrics"},{"key":"e_1_2_8_52_1","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1002\/psp4.13202","article-title":"A guide to developing population files for physiologically\u2010based pharmacokinetic modeling in the Simcyp Simulator","volume":"13","author":"Curry L","year":"2024","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"key":"e_1_2_8_53_1","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1002\/cpt.3307","article-title":"Oral drug dosing after gastric bypass and diet\u2010induced weight loss: simpler than we think? Lessons learned from the COCKTAIL study","volume":"116","author":"Kvitne KE","year":"2024","journal-title":"Clin Pharmacol Ther"},{"key":"e_1_2_8_54_1","doi-asserted-by":"crossref","first-page":"4121","DOI":"10.1111\/bcp.15349","article-title":"Short\u2010 and long\u2010term effects of body weight, calorie restriction and gastric bypass on CYP1A2, CYP2C19 and CYP2C9 activity","volume":"88","author":"Kvitne KE","year":"2022","journal-title":"Br J Clin Pharmacol"},{"key":"e_1_2_8_55_1","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1002\/psp4.13189","article-title":"Impact of obesity and roux\u2010en\u2010Y gastric bypass on the pharmacokinetics of (R)\u2010 and (S)\u2010omeprazole and intragastric pH","volume":"13","author":"Pippa LF","year":"2024","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"key":"e_1_2_8_56_1","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1002\/oby.24124","article-title":"Maternal obesogenic diet during pregnancy and its impact on fetal hepatic function in baboons","volume":"32","author":"Meakin AS","year":"2024","journal-title":"Obesity (Silver Spring)"},{"key":"e_1_2_8_57_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ejps.2012.05.008","article-title":"Consumption of a high\u2010fat diet during pregnancy decreases the activity of cytochrome P450 3a in the livers of offspring","volume":"47","author":"Tajima M","year":"2012","journal-title":"Eur J Pharm Sci"},{"key":"e_1_2_8_58_1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1080\/01443615.2019.1706157","article-title":"Prevalence and impact of pre\u2010pregnancy body mass index on pregnancy outcome: a cross\u2010sectional study in Croatia","volume":"41","author":"Vince K","year":"2021","journal-title":"J Obstet Gynaecol"},{"key":"e_1_2_8_59_1","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1161\/HYPERTENSIONAHA.124.24394","article-title":"Vascular assessment stratifying preeclampsia risk in overweight\/obese women","volume":"82","author":"Chatzakis C","year":"2025","journal-title":"Hypertension"},{"key":"e_1_2_8_60_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jsbmb.2013.02.014","article-title":"Cytochrome P450\u2010mediated metabolic alterations in preeclampsia evaluated by quantitative steroid signatures","volume":"139","author":"Moon J\u2010Y","year":"2014","journal-title":"J Steroid Biochem Mol Biol"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms\/163132"},{"key":"e_1_2_8_62_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2010.06.029","article-title":"Betamethasone in pregnancy: influence of maternal body weight and multiple gestation on pharmacokinetics","volume":"203","author":"Della Torre M","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_63_1","doi-asserted-by":"crossref","first-page":"219.e1","DOI":"10.1016\/j.ajog.2010.04.047","article-title":"The effect of plurality and obesity on betamethasone concentrations in women at risk for preterm delivery","volume":"203","author":"Gyamfi C","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_64_1","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1093\/humrep\/13.4.799","article-title":"11Beta\u2010hydroxysteroid dehydrogenase type 2 in human pregnancy and reduced expression in intrauterine growth restriction","volume":"13","author":"Shams M","year":"1998","journal-title":"Hum Reprod"},{"key":"e_1_2_8_65_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1530\/eje.0.1450187","article-title":"Course of placental 11beta\u2010hydroxysteroid dehydrogenase type 2 and 15\u2010hydroxyprostaglandin dehydrogenase mRNA expression during human gestation","volume":"145","author":"Schoof E","year":"2001","journal-title":"Eur J Endocrinol"},{"key":"e_1_2_8_66_1","doi-asserted-by":"crossref","first-page":"4393","DOI":"10.1111\/ejn.16184","article-title":"Obesity in pregnancy\u2010Long\u2010term effects on offspring hypothalamic\u2010pituitary\u2010adrenal axis and associations with placental cortisol metabolism: a systematic review","volume":"58","author":"Volqvartz T","year":"2023","journal-title":"Eur J Neurosci"},{"key":"e_1_2_8_67_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.placenta.2023.10.011","article-title":"Placental pathologic features in obesity","volume":"144","author":"Beneventi F","year":"2023","journal-title":"Placenta"},{"key":"e_1_2_8_68_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/0002-9378(78)90768-8","article-title":"The transfer and metabolism of corticosteroids in the perfused human placenta","volume":"132","author":"Levitz M","year":"1978","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_8_69_1","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1080\/17425255.2018.1499726","article-title":"An update on expression and function of P\u2010gp\/ABCB1 and BCRP\/ABCG2 in the placenta and fetus","volume":"14","author":"Han LW","year":"2018","journal-title":"Expert Opin Drug Metabo Toxicol"},{"key":"e_1_2_8_70_1","doi-asserted-by":"crossref","DOI":"10.3390\/ijms241713089","article-title":"Changes in Expression and Function of Placental and Intestinal P\u2010gp and BCRP Transporters during Pregnancy","volume":"24","author":"Szatm\u00e1ri P","year":"2023","journal-title":"Int J Mol Sci"},{"key":"e_1_2_8_71_1","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.placenta.2005.05.007","article-title":"Expression of the multidrug resistance P\u2010glycoprotein, (ABCB1 glycoprotein) in the human placenta decreases with advancing gestation","volume":"27","author":"Sun M","year":"2006","journal-title":"Placenta"},{"key":"e_1_2_8_72_1","doi-asserted-by":"crossref","first-page":"6976","DOI":"10.3390\/ijms26146976","article-title":"Alterations in P\u2010glycoprotein expression in the placenta of obese rats and humans","volume":"26","author":"Szatm\u00e1ri P","year":"2025","journal-title":"IJMS"},{"key":"e_1_2_8_73_1","doi-asserted-by":"crossref","first-page":"5175","DOI":"10.1038\/s41598-023-31598-5","article-title":"ABCB1 expression is increased in human first trimester placenta from pregnant women classified as overweight or obese","volume":"13","author":"Justesen S","year":"2023","journal-title":"Sci Rep"}],"container-title":["The Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.70308","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcph.70308","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcph.70308","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:10:54Z","timestamp":1791969054000},"score":1,"resource":{"primary":{"URL":"https:\/\/accp1.onlinelibrary.wiley.com\/doi\/10.1002\/jcph.70308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":72,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/jcph.70308"],"URL":"https:\/\/doi.org\/10.1002\/jcph.70308","archive":["Portico"],"relation":{},"ISSN":["0091-2700","1552-4604"],"issn-type":[{"value":"0091-2700","type":"print"},{"value":"1552-4604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70308"}}