In healthy pregnancy, glucose and oxygen availability are essential for fetal growth and well being. However, how substrate delivery and fetal uptake are affected in human pregnancy complicated by fetal growth restriction (FGR) is still unknown. Here, we show that the human FGR fetus has a strikingly reduced umbilical uptake of both oxygen and glucose. In 30 healthy term and 32 FGR human pregnancies, umbilical volume flow (Qumb) and parallel umbilical vein (uv) and artery (ua) blood samples were obtained at elective Cesarean section to calculate fetal glucose and oxygen uptake as Qumb · à (uv−ua) differences. Umbilical blood flow was significantly lower in FGR pregnancy (−63%; P<0.001) but not when normalized for fetal body weight. FGR pregnancy had significantly lower umbilical oxygen delivery and uptake, both as absolute values (delivery: −78%; uptake: −78%) and normalized (delivery: −50%; uptake: −48%) for fetal body weight (all P<0.001). Umbilical glucose absolute delivery and uptake were significantly reduced (delivery: −68%; uptake: −72%) but only glucose uptake was decreased when normalized for fetal body weight (−30%; P<0.05). The glucose/oxygen quotient was significantly increased (+100%; P<0.05) while glucose clearance was significantly decreased (71%; P<0.001) in FGR pregnancy (both P<0.05). The human fetus in FGR pregnancy triggers compensatory mechanisms to reduce its metabolic rate, matching the proportion of substrate consumption relative to oxygen delivery as a survival strategy during complicated pregnancy.

Fetal oxygen and glucose consumption in human pregnancy complicated by fetal growth restriction / I. Cetin, E. Taricco, C. Mando', T. Radaelli, S. Boito, A. Maria Nuzzo, D.A. Giussani. - In: HYPERTENSION. - ISSN 0194-911X. - 75:3(2020 Mar), pp. 748-754. [10.1161/HYPERTENSIONAHA.119.13727]

Fetal oxygen and glucose consumption in human pregnancy complicated by fetal growth restriction

I. Cetin
;
E. Taricco;C. Mando';T. Radaelli;
2020

Abstract

In healthy pregnancy, glucose and oxygen availability are essential for fetal growth and well being. However, how substrate delivery and fetal uptake are affected in human pregnancy complicated by fetal growth restriction (FGR) is still unknown. Here, we show that the human FGR fetus has a strikingly reduced umbilical uptake of both oxygen and glucose. In 30 healthy term and 32 FGR human pregnancies, umbilical volume flow (Qumb) and parallel umbilical vein (uv) and artery (ua) blood samples were obtained at elective Cesarean section to calculate fetal glucose and oxygen uptake as Qumb · à (uv−ua) differences. Umbilical blood flow was significantly lower in FGR pregnancy (−63%; P<0.001) but not when normalized for fetal body weight. FGR pregnancy had significantly lower umbilical oxygen delivery and uptake, both as absolute values (delivery: −78%; uptake: −78%) and normalized (delivery: −50%; uptake: −48%) for fetal body weight (all P<0.001). Umbilical glucose absolute delivery and uptake were significantly reduced (delivery: −68%; uptake: −72%) but only glucose uptake was decreased when normalized for fetal body weight (−30%; P<0.05). The glucose/oxygen quotient was significantly increased (+100%; P<0.05) while glucose clearance was significantly decreased (71%; P<0.001) in FGR pregnancy (both P<0.05). The human fetus in FGR pregnancy triggers compensatory mechanisms to reduce its metabolic rate, matching the proportion of substrate consumption relative to oxygen delivery as a survival strategy during complicated pregnancy.
fetus; glucose; oxygen consumption; pregnancy; umbilical vein
Settore MED/40 - Ginecologia e Ostetricia
Settore MED/49 - Scienze Tecniche Dietetiche Applicate
mar-2020
Article (author)
File in questo prodotto:
File Dimensione Formato  
Cetin et al 2019_Hypertension_Fetal Oxygen and Glucose Consumption in Human Pregnancy Complicated by Fetal Growth Restriction.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 442.75 kB
Formato Adobe PDF
442.75 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/702396
Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus 35
  • ???jsp.display-item.citation.isi??? 29
social impact