Catecholamine release from the adrenal medulla glands plays a vital role in postnatal adaptation. A number of pathologic situations are characterized by oxygen deficiency. The objective of the present study was to determine the influence of long-term prenatal hypoxia on maturation of the adrenal medulla. Pregnant rats were subjected to hypoxia (10% O 2 ) from the fifth to the 20th d of gestation. The offspring were examined on the 19th d of gestation (E19), the day of birth (P0), and at postnatal (P) day of life P3, P7, P14, P21, and P68. The catecholamine content and activity of tyrosine hydroxylase (TH) in vivo were assayed by HPLC with electrochemical detection. Cellular expression of TH and phenylethanolamine N-methyl transferase was evaluated by protein immunohistochemistry and in situ hybridization of the corresponding mRNA species. Exposure to prenatal hypoxia reduced the epinephrine content of the adrenal medulla on E19, P0, P3, and P7 while increasing the norepinephrine content on E19, P0, and P14. Furthermore, the peak epinephrine to norepinephrine ratio appearing between P7 and P10 in the normoxic offspring was absent in the hypoxic offspring. The in vivo TH activity was increased on P3 and P14 and decreased on P68. The percentage of chromaffin cells in the medulla expressing TH and phenylethanolamine N-methyl transferase was lowered on E19, P0, and P7. TH and phenylethanolamine N-methyl transferase mRNA levels were reduced on P7. Clearly prenatal hypoxia results in major changes in adrenal catecholamine stores and synthesis during the perinatal period, which persist into adulthood. The capacity to cope with postnatal stress might be disturbed as a consequence of prenatal hypoxia. The release of catecholamines plays an essential role in initial adaptation to extrauterine life, particularly in connection with perinatal asphyxia (1). Circulating catecholamines originate to a large extent from the adrenal medulla glands and serve vital functions in relation with cardiovascular, respiratory, and metabolic responses to the stress associated with birth (1-4). In the rat, the chromaffin cells of the adrenal medulla are still immature at the time of birth and undergo extensive biochemical, morphologic, and functional changes during postnatal development.Catecholamine synthesis is catalyzed by cytoplasmic enzymes, including TH, which represents the rate-limiting step, and PNMT, which catalyzes the biosynthesis of E. At birth, increases in both the plasma and adrenal levels of catecholamines occur (5, 6). Marked increases in the levels of TH mRNA and of dopamine -hydroxylase mRNA are observed in the adrenal, thus reflecting the surge in catecholamines at the