Oxygen delivery and fetal-placental growth: Beyond a question of supply and demand?

Murray, A.J.

doi:10.1016/j.placenta.2012.06.006

Cited by 129Pregnancy and preeclampsia studiesBirth, Development, and HealthNeonatal and fetal brain pathology

Oxygen delivery and fetal-placental growth: Beyond a question of supply and demand?

Murray, A.J.·2012·Placenta

DOI 10.1016/j.placenta.2012.06.006

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Abstract

Towards the end of the first trimester, blood flow and oxygenation rise within the placenta, supporting an increased capacity for mitochondrial oxidative metabolism in both the placenta and developing fetus. In this regard, the placenta acts uniquely as both a conduit of oxygen to the fetal circulation and a significant consumer of oxygen in order to support its own energy demands for the processes of nutrient transport and protein synthesis for hormone production and growth. When the supply of oxygen becomes restricted, for example during chronic exposure to hypobaric hypoxia at high altitude, placental and fetal tissues respond in order to optimise the allocation of oxygen between competing demands. In this case, the placenta appears to remodel its metabolism to decrease oxygen consumption, probably by increasing ATP production via glycolysis. This process can maintain oxygen supply to the fetus but is still associated with growth restriction. Oxidative stress, a feature of pre-eclampsia, might elicit similar metabolic changes in the absence of hypoxia. This review considers what is known about the metabolic response of the placenta and fetal tissues to hypoxia and oxidative stress, and suggests possible mechanisms that might underlie such metabolic remodelling using lessons from other tissues and organ systems. Aspects of the hypoxia response that remain to be addressed are highlighted and future studies suggested. Much remains unknown about the coordinated metabolic response of the fetal-placental unit to chronic hypoxia and oxidative stress, but it would appear to be more than a simple question of supply and demand.

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Fetal oxygen consumption must therefore be maintained by oxidation of substrates other than glucose, such as amino acids and/or fats, which will then reduce their availability for other purposes.
“Fetal oxygen consumption must, therefore, be maintained by oxidation of substrates other than glucose, such as amino acids and/or fats, which will then reduce their availability for other purposes (403).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [403]
Collectively, these observations suggest that the chronically hypoxic placenta at high altitude may switch from oxidative phosphorylation to a greater dependence on anaerobic glycolysis to meet its ATP requirements, which may increase fetal oxygen availability albeit at the expense of the fetal glucose supply.
“Collectively, these observations suggest that the chronically hypoxic placenta at high altitude may switch from oxidative phosphorylation to a greater dependence on anaerobic glycolysis to meet its ATP requirements, which may increase fetal oxygen availability albeit at the expense of the fetal glucose supply (271, 403).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [403]

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Retracted
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Gestational differences in murine placenta: Glycolytic metabolism and pregnancy parameters
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Pathophysiologic and Anaesthetic Considerations in Iron Deficiency Anaemia and Pregnancy; An Update
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Authors: Murray, A. J.
Affiliations: University of Cambridge (GB)
Corresponding author: Murray, A.J.
ORCID: Murray, A.J.
Venue: Placenta
Publisher: Elsevier BV
Published: 2012-11
Volume: 33
Pages: e16-e22
ISSN: 0143-4004 (ISSN-L)
DOI: 10.1016/j.placenta.2012.06.006
OpenAlex: W2094996169
Cited by: 129
References: 66
Citations by year: 2026: 7 · 2025: 16 · 2024: 4 · 2023: 9 · 2022: 8 · 2021: 14 · 2020: 10 · 2019: 3 · 2018: 13 · 2017: 10 · 2016: 9 · 2015: 10 · 2014: 8 · 2013: 6 · 2012: 2
FWCI: 10.03
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Placenta (publishedVersion)
PubMed (publishedVersion)
Funders: Action Medical Research
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
Keywords: hypoxia, oxidative stress, placental metabolism, mitochondrial oxidative metabolism, glycolysis, ATP production, high altitude, fetal growth restriction, preeclampsia, placental energy metabolism
MeSH terms: Altitude, Animals, Hypoxia, Female, Fetal Blood, Humans, Mitochondria, Oxygen, Oxygen Consumption, Placenta, Placenta Diseases, Placentation, Pre-Eclampsia, Pregnancy, Oxidative Stress, Fetal Development

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Oxygen delivery and fetal-placental growth: Beyond a question of supply and demand?

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