Effects of hypobaric hypoxia on the fetoplacental unit: The morphometric diffusing capacity of the villous membrane at high altitude
Abstract
Objective Our purpose was to determine whether the human placenta is able to adapt structurally to hypobaric hypoxia so as to increase its diffusing capacity.Study design Material from 10 normal term placentas collected at each of three altitudinal levels in Kirghizstan was analyzed stereologically. Data were compared by one-way analysis of variance.Results Within the overall sample group birth weight and placental weight remained constant. There were no differences in villous and capillary surface areas or capillary length, but capillary volume increased from 37.9 cm3 in controls (700 m) to 50.8 cm3 at high altitude (2200 to 2800 m). The harmonic mean thickness fell from 6.9 microns in controls to 4.8 microns at high altitude. Consequently, the morphometric diffusing capacity of the villous membrane for oxygen increased from 4.22 to 7.56 cm3.min-1.mm Hg-1 (F = 6.45, p < 0.05).Conclusions The placenta is capable of adapting to hypobaric hypoxia to increase its functional capacity for gaseous exchange. This is principally through a reduction in the thickness of the villous membrane.
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Under limiting conditions such as pregnancy at high altitude, changes in surface area or membrane thickness may be adaptive responses to facilitate exchange.
“However, under limiting conditions, such as pregnancy at high altitude, changes in surface area or membrane thickness may be considered adaptive responses to facilitate exchange (275, 369, 458).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [458]
Studies show no consistent effect of chronic hypoxia on placental weight or size, with increases, decreases and no change depending on the study and/or population.
“These show no consistent effect of chronic hypoxia on placental weight or size with increases, decreases and no change depending on the study and/or population.”
From Placental Origins of Chronic Disease (2016) · cites this paper as [458]
There is thinning of the interhemal membrane in the human placenta at high altitude.
“In addition, there is thinning of the interhemal membrane in the human placenta at high altitude (276, 366, 458).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [458]
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Wee, L., Sebire, N. J., Bhundia, J., Sullivan, M. H. F., & Fisk, N. M. (2005) · Placenta · doi:10.1016/j.placenta.2005.02.020 · Cited by 15 · see citing works
Placental Gas Exchange and the Oxygen Supply to the Fetus
Carter, A. M. (2015) · Comprehensive physiology · doi:10.1002/j.2040-4603.2015.tb00648.x · Cited by 11 · see citing works
Aksoy, A. N., Batmaz, G., Dane, B., Kucur, S. K., & Gözükara, İ. (2015) · Journal of the Turkish-German Gynecological Association · doi:10.5152/jtgga.2015.15134 · Cited by 11 · see citing works
Global population variation in placental size and structure: Evidence from Cebu, Philippines
Rutherford, J. N., deMartelly, V. A., Ragsdale, H. B., Avila, J. L., Lee, N. R., & Kuzawa, C. W. (2019) · Placenta · doi:10.1016/j.placenta.2019.08.076 · Cited by 11 · see citing works
Clinical Care in Extreme Environments: At High and Low Pressure and in Space
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Benign Tumors and Chorangiosis
Benirschke, K., Burton, G. J., & Baergen, R. N. (2012) · Springer eBooks · doi:10.1007/978-3-642-23941-0_24 · Cited by 10 · see citing works
Self-citationHistopathological Approach to Villous Alterations
Benirschke, K., Burton, G. J., & Baergen, R. N. (2012) · Springer eBooks · doi:10.1007/978-3-642-23941-0_14 · Cited by 10 · see citing works
Self-citationBenirschke, K., & Kaufmann, P. (2000) · Springer eBooks · doi:10.1007/978-1-4757-4199-5_24 · Cited by 10 · see citing works
Uterine blood flow as a determinant of fetoplacental development
Moore, L. G. (2010) · The Placenta and Human Developmental Programming · doi:10.1017/cbo9780511933806.012 · Cited by 9 · see citing works
Ali, K. Z. M., Burton, G. J., Al-Binali, A. M., Eskandar, M. A., El-Mekki, A. A., Moosa, R. A., Abd-Alla, S. A., Salih, A. G. A., Sideeg, A. M., & Mahfouz, A. A. (2012) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2012.667462 · Cited by 10 · see citing works
Self-citationHistomorphometric parameters of normal full term placenta of Sudanese women
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Altered placental development in pregnancies resulting in sudden infant death syndrome (SIDS)
Widdows, K. L., O'Malley, A., O'Neill, B., Kingdom, J. C., Gillan, J., & Ansari, T. (2012) · Early Human Development · doi:10.1016/j.earlhumdev.2012.05.006 · Cited by 8 · see citing works
Vascularization of the Placenta
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Aplin, J., & Jones, C. J. P. (2008) · Reproductive medicine and assisted reproductive techniques series · doi:10.3109/9780203091500.030 · Cited by 8 · see citing works
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Kuzawa, C. W. (1998) · doi:10.1002/(sici)1096-8644(1998)107:27+
- Authors
- Reshetnikova, O. S., Burton, G. J., & Milovanov, A. P.
- Affiliations
- Luhansk State Medical University (UA)
- University of Cambridge (GB)
- Corresponding author
- Burton, Graham J.
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1994-12
- Volume
- 171
- Issue
- 6
- Pages
- 1560-1565
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W1998471670
- Cited by
- 127
- References
- 26
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 2 · 2019: 2 · 2018: 4 · 2016: 4 · 2015: 9 · 2014: 1 · 2013: 3 · 2012: 11
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- hypobaric hypoxia, high altitude, placenta, fetoplacental unit, diffusing capacity for carbon monoxide, placental adaptation, gas exchange, capillary volume, stereology, term placenta
- MeSH terms
- Altitude, Hypoxia, Atmospheric Pressure, Birth Weight, Capillaries, Diffusion, Female, Fetus, Humans, Microvilli, Placenta, Pregnancy
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