![]() ![]() The adrenals are maybe the most fascinating organs of the human body with the structure and function of the fetal adrenals being significantly different compared to the postnatal and adult organs. Finally, we discuss what we think are the major open questions in the field, including, among others, the impact of osteocalcin, thyroid hormone, and other hormone systems on adrenal development and function, and the reliability of rodents as models of adrenal pathophysiology. Here, we review and discuss the most recent advances in our understanding of embryonic and fetal adrenal development, including the known causes for adrenal dys-/agenesis, and the steroidogenic pathways that link the fetal adrenal with the hormone system of the mother through the fetal-placental unit. ![]() In particular, the steroidogenic activity of the fetal adrenal is instrumental in maintaining normal fetal development and growth. ![]() A fully functional adrenal cortex relies on the proper subdivision in regions or ‘zones’ with distinct but interconnected functions, which evolve from the early embryonic stages to adulthood, and rely on a fine-tuned gene network. The adrenal cortex undergoes multiple structural and functional rearrangements to satisfy the systemic needs for steroids during fetal life, postnatal development, and adulthood. ![]()
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