The placenta in fetal growth restriction: What is going wrong?
Open accessAbstract
The placenta is essential for the efficient delivery of nutrients and oxygen from mother to fetus to maintain normal fetal growth. Dysfunctional placental development underpins many pregnancy complications, including fetal growth restriction (FGR) a condition in which the fetus does not reach its growth potential. The FGR placenta is smaller than normal placentae throughout gestation and displays maldevelopment of both the placental villi and the fetal vasculature within these villi. Specialized epithelial cells called trophoblasts exhibit abnormal function and development in FGR placentae. This includes an altered balance between proliferation and apoptotic death, premature cellular senescence, and reduced colonisation of the maternal decidual tissue. Thus, the placenta undergoes aberrant changes at the macroscopic to cellular level in FGR, which can limit exchange capacity and downstream fetal growth. This review aims to compile stereological, in vitro, and imaging data to create a holistic overview of the FGR placenta and its pathophysiology, with a focus on the contribution of trophoblasts.
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The placenta plays an important role in the pathogenesis of obstetric complications such as placenta previa, abnormally invasive placenta, fetal growth restriction, and hypertensive disorders of pregnancy.
“The placenta is known to play an important role in the pathogenesis of obstetric complications such as placenta previa, abnormally invasive placenta, fetal growth restriction, and hypertensive disorders of pregnancy [105].”
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- Authors
- Sun, C., Groom, K. M., Oyston, C., Chamley, L. W., Clark, A. R., & James, J. L.
- Affiliations
- University of Auckland (NZ)
- Corresponding author
- Sun, Cherry
- Venue
- Placenta
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 96
- Pages
- 10-18
- ISSN
- 0143-4004 (ISSN-L)
- OpenAlex
- W3024316689
- Cited by
- 253
- References
- 137
- Citations by year
- 2026: 48 · 2025: 58 · 2024: 52 · 2023: 44 · 2022: 37 · 2021: 10 · 2020: 3 · 2014: 1
- FWCI
- 14.25
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Placenta (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion, cc-by)
- Funders
- Nurture Foundation for Reproductive Research
- Auckland Medical Research Foundation
- Health Research Council of New Zealand
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- fetal growth restriction, placental insufficiency, trophoblast, placental villi, placental vasculature, cellular senescence, stereology, placental pathophysiology
- MeSH terms
- Animals, Chorionic Villi, Female, Fetal Growth Retardation, Humans, Infant, Newborn, Infant, Small for Gestational Age, Placenta, Placentation, Pregnancy, Trophoblasts
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