Targeted drug delivery for maternal and perinatal health: Challenges and opportunities

Abstract

Pre-existing conditions at reproductive age, and complications arising during pregnancy can be detrimental to maternal and fetal health. Current therapies to combat obstetric disorders are limited due to the inherent complexity of pregnancy, and can have harmful effects on developing fetus. Emerging research shows intricate signaling between the cells from mother and fetus at maternal-fetal interface, providing unique opportunities for interventions specifically targeted to the mother, fetus, or placenta. Advancements in nanotechnology, stem-cell biology and gene therapy have resulted in target-specific treatments with promising results in pre-clinical maternal and fetal disorder models. Comprehensive understanding of the effect of physicochemical properties of delivery systems on their uptake, retention and accumulation across placenta will help in the better diagnosis and treatment of perinatal disorders. This review describes the factors leading to obstetric complications along with their effect on pregnancy outcomes, and discusses key targeted therapeutic strategies for addressing conditions related to maternal and fetal health.

Keywords: Maternal and fetal nanomedicine; Nanoparticles; Obstetric complications; Perinatal health; Targeted drug delivery.

Figure 1.

Schematic illustration demonstrating benefits of targeted drug delivery and nanomedicines in maternal and perinatal health. Nanotechnology mediated controlled drug and gene delivery specifically targeted to mother, placenta, and fetus may provide novel avenues for treating obstetric complications without harming mother and the fetus.

Figure 2.

Schematic illustration of the implications of maternal insult on pregnancy outcomes. The figure summarizes the maternal conditions, both pre-existing and developed during pregnancy, along with their effects on maternal and perinatal health. The red arrows indicate the temporal evolution of different disease phenotypes in the fetus (left), and the mother (right).

Figure 3.

Illustration of the role of placenta and the maternal-fetal interface. The placenta represents the connection between the mother and the fetus, and constitutes syncytiotrophoblast, cytotrophoblast, embryonic connective tissue, and endothelial cells of fetal blood vessels.

Figure 4.

Illustration of molecular transport through placenta. Figure represents various mechanisms of placental molecular transport via active and passive routes at the maternal-fetal interface.

Figure 5.

Toxic effects of NPs exposure during pregnancy. NPs may exert toxic effects on maternal health, placenta and fetal development and detailed toxicological studied of nanomedicines will be of utmost importance to make use of the modern nanotechnology for safe treatment of obstetric complications.