Pregnancy at high altitude in the Andes leads to increased total vessel density in healthy newborns

Norina N Gassmann; Hugo A van Elteren; Tom G Goos; Claudia R Morales; Maria Rivera-Ch; Daniel S Martin; Patricia Cabala Peralta; Agustin Passano Del Carpio; Saul Aranibar Machaca; Luis Huicho; Irwin K M Reiss; Max Gassmann; Rogier C J de Jonge

doi:10.1152/japplphysiol.00561.2016

Pregnancy at high altitude in the Andes leads to increased total vessel density in healthy newborns

J Appl Physiol (1985). 2016 Sep 1;121(3):709-15. doi: 10.1152/japplphysiol.00561.2016. Epub 2016 Jul 21.

Affiliations

¹ Institute of Veterinary Physiology, Vetsuisse Faculty, and Zurich Center for Integrative Human Physiology (ZIHP), Medical Faculty, University of Zurich, Zurich, Switzerland; Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands;
² Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands;
³ Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, University Medical Center, Rotterdam, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands;
⁴ Laboratory of Adaptation to High Altitude, Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru;
⁵ Laboratory of Adaptation to High Altitude, Universidad Peruana Cayetano Heredia (UPCH), Lima, Peru; Center of Research for Integral and Sustainable Development (CIDIS), UPCH, Lima, Peru;
⁶ University College London Centre for Altitude Space and Extreme Environment Medicine, Univesity College London Hospital (UCLH) National Institute for Health Research (NIHR) Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom;
⁷ Hospital III Puno EsSalud, Puno, Peru; and.
⁸ Center of Research for Integral and Sustainable Development (CIDIS), UPCH, Lima, Peru; School of Medicine, UPCH, Lima, Peru.
⁹ Institute of Veterinary Physiology, Vetsuisse Faculty, and Zurich Center for Integrative Human Physiology (ZIHP), Medical Faculty, University of Zurich, Zurich, Switzerland; School of Medicine, UPCH, Lima, Peru maxg@access.uzh.ch.

Abstract

The developing human fetus is able to cope with the physiological reduction in oxygen supply occurring in utero. However, it is not known if microvascularization of the fetus is augmented when pregnancy occurs at high altitude. Fifty-three healthy term newborns in Puno, Peru (3,840 m) were compared with sea-level controls. Pre- and postductal arterial oxygen saturation (SpO2) was determined. Cerebral and calf muscle regional tissue oxygenation was measured using near infrared spectroscopy (NIRS). Skin microcirculation was noninvasively measured using incident dark field imaging. Pre- and postductal SpO2 in Peruvian babies was 88.1 and 88.4%, respectively, which was 10.4 and 9.7% lower than in newborns at sea level (P < 0.001). Cerebral and regional oxygen saturation was significantly lower in the Peruvian newborns (cerebral: 71.0 vs. 74.9%; regional: 68.5 vs. 76.0%, P < 0.001). Transcutaneously measured total vessel density in the Peruvian newborns was 14% higher than that in the newborns born at sea level (29.7 vs. 26.0 mm/mm(2); P ≤ 0.001). This study demonstrates that microvascular vessel density in neonates born to mothers living at high altitude is higher than that in neonates born at sea level.

Keywords: hypoxia; incident dark field imaging; microcirculation; near infrared spectroscopy; neonates; oxygen profiling.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Acclimatization / physiology*
Adult
Altitude*
Female
Humans
Infant, Newborn / physiology*
Male
Microcirculation / physiology*
Microvessels / anatomy & histology*
Microvessels / physiology*
Peru
Pregnancy / physiology*
Prospective Studies
Young Adult