The Role of 7-ketocholesterol in Placental Pathophysiology: Implications for Fetal Programming and Long-term Health: A Narrative Review.

7-Ketocholesterol (7-KC), a major cholesterol oxidation product, is increasingly recognized as a potent mediator of oxidative stress, inflammation, and cellular dysfunction. While its roles in cardiovascular and neurodegenerative diseases are well established, its significance at the maternal-fetal interface remains poorly understood. This narrative review summarizes current evidence on the sources, placental transport, metabolism, and biological effects of 7-KC during pregnancy. Emerging studies suggest that 7-KC may impair trophoblast function, disrupt placental homeostasis, and influence fetal developmental pathways. Within the Developmental Origins of Health and Disease (DOHaD) framework, 7-KC represents a potential mediator linking adverse intrauterine environments to long-term offspring health outcomes, highlighting important directions for future research.