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Advances in artificial intelligence and multi-omic analysis are transforming fetal medicine from a diagnostic discipline into a predictive one. Yet the legal, deontological, and ethical frameworks that govern prenatal and fetal data have not evolved accordingly. Current regulations protect the mother as a patient but do not recognize the fetus—or the future child—as a legal data subject. As a result, information generated before birth remains confined within maternal medical records, creating uncertainty about who may later access or reuse it. This paper examines the emerging ethical and legal challenges of predictive fetal medicine, focusing on the transition from maternal consent to the child’s future right to their own prenatal data. Through the lens of professional deontology and comparative law, we analyze the tensions between confidentiality, autonomy, and beneficence. We propose a framework of prenatal data stewardship, shifting from static notions of data ownership to shared responsibility across time. Establishing national or international repositories under transparent governance could enable ethical reuse of fetal data while safeguarding maternal privacy and ensuring future individuals’ rights. Ultimately, aligning predictive fetal medicine with ethical and legal coherence requires collective action among clinicians, ethicists, jurists, policymakers, and industry. Only through such stewardship can information generated before birth become a trusted tool for care rather than control.

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