Placental transport in pregnancy pathologies

Am J Clin Nutr. 2011 Dec;94(6 Suppl):1896S-1902S. doi: 10.3945/ajcn.110.000851. Epub 2011 May 4.

Abstract

The placenta is positioned between the maternal and fetal circulation and hence plays a key role in transporting maternal nutrients to the developing fetus. Fetal growth changes in the 2 most frequent pregnancy pathologies, gestational diabetes mellitus and fetal growth restriction, are predominantly characterized by an exaggerated and restricted fat accretion, respectively. Glucose, by its regulating effect on fetal insulin concentrations, and lipids have been strongly implicated in fetal fat deposition. Transplacental glucose flux is highly efficient and limited only by nutrient availability (flow-limited)--ie, driven by the maternal-fetal glucose concentration gradient and blood flow, with little, if any, effect of placental morphology, glucose consumption, and transporter expression. This explains why, despite changes in these determinants in both pathologies, transplacental glucose flux is unaltered.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / analysis
  • Diabetes, Gestational / pathology*
  • Female
  • Fetal Development / drug effects
  • Fetal Growth Retardation / pathology*
  • Fetus / metabolism
  • Fetus / physiopathology
  • Humans
  • Insulin / metabolism
  • Lipase / genetics
  • Lipase / metabolism
  • Placenta / blood supply*
  • Placental Circulation / drug effects*
  • Pregnancy
  • Pregnancy Complications / pathology*
  • Receptors, Lipoprotein / metabolism

Substances

  • Blood Glucose
  • Insulin
  • Receptors, Lipoprotein
  • Lipase