Placental transport in pregnancy pathologies1234

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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.

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1

From the Department of Obstetrics and Gynaecology (GD and CW) and the Institute of Cell Biology, Histology and Embryology; Medical University of Graz, Graz, Austria (MG).

2

Presented at the conference “The Power of Programming: Developmental Origins of Health and Disease,” held in Munich, Germany, 6–8 May 2010.

3

Supported by the Commission of the European Communities, grant QLK1-2001-00138 (“Influence of Dietary Fatty Acids on the Pathophysiology of Intrauterine Foetal Growth and Neonatal Development” (PeriLip), and by grants 7361 and 10053 (to GD) and 11165 and 13533 (to CW). The preparation of the manuscript was supported by grant 1260, the all Jubilee Fund, and the Austrian National Bank, Vienna. GD’s work was also supported by grants P10900 and P13721-MED of the Austrian Science Foundation, Vienna. MG is currently supported by the START funding program of the Medical University of Graz.

4

Address correspondence to G Desoye, Department of Obstetrics and Gynaecology, Auenbruggerplatz 14, A-8036 Graz, Austria. E-mail: [email protected].

Copyright © 2011 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.