Humans at high altitude: Hypoxia and fetal growth
Open accessAbstract
High-altitude studies offer insight into the evolutionary processes and physiological mechanisms affecting the early phases of the human lifespan. Chronic hypoxia slows fetal growth and reduces the pregnancy-associated rise in uterine artery (UA) blood flow. Multigenerational vs. shorter-term high-altitude residents are protected from the altitude-associated reductions in UA flow and fetal growth. Presently unknown is whether this fetal-growth protection is due to the greater delivery or metabolism of oxygen, glucose or other substrates or to other considerations such as mechanical factors protecting fragile fetal villi, the creation of a reserve protecting against ischemia/reperfusion injury, or improved placental O(2) transfer as the result of narrowing the A-V O(2) difference and raising uterine P(v)O₂. Placental growth and development appear to be normal or modified at high altitude in ways likely to benefit diffusion. Much remains to be learned concerning the effects of chronic hypoxia on embryonic development. Further research is required for identifying the fetoplacental and maternal mechanisms responsible for transforming the maternal vasculature and regulating UA blood flow and fetal growth. Genomic as well as epigenetic studies are opening new avenues of investigation that can yield insights into the basic pathways and evolutionary processes involved.
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The high-altitude decline in birth weight is less in populations with longer residency at high altitude, such as Tibetans and Andeans, than in populations like Han and Europeans who have settled at altitude more recently.
“However, the high-altitude decline in birth weight is less in populations with longer residency at high altitude, such as the Tibetans and Andeans, than in populations like the Han and Europeans who have settled at altitude more recently (214, 387, 443).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [387]
On average, there is a 100g decrease in birth weight per 1000m elevation in altitude, although the exact figure varies with the ethnicity of the population.
“On average, there is a 100g decrease in birth weight per 1000m elevation in altitude, although the exact figure varies with the ethnicity of the population (387).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [387]
In human populations, the adverse consequences of high altitude on uterine artery diameter and uterine blood flow are less pronounced with long than short ancestry at high altitude.
“In human populations, the adverse consequences of high altitude on uterine artery diameter and uterine blood flow are less pronounced with long than short ancestry at high altitude (295, 387).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [387]
Hypoxia affects both the placenta and fetus and is associated with impaired trophoblast invasion, poor villous development, altered vascularity, reduced spiral artery remodelling and low blood flow on both sides of the placenta.
“It affects both the placenta and fetus and is associated with impaired trophoblast invasion, poor villous development, altered vascularity, reduced spiral artery remodelling and low blood flow on both sides of the placenta (387, 543, 600).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [387]
Overall amongst species, the morphological adaptations of the placenta will increase its oxygen diffusion capacity and aid oxygen delivery to the fetus at low maternal pO2.
“Overall amongst species, the morphological adaptations of the placenta will increase its oxygen diffusion capacity and aid oxygen delivery to the fetus at low maternal pO2 (370, 387, 431).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [387]
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Allam, G. A., Alsulaimani, A. A., Alghamdi, H. A., Alswat, H., Edrees, B., Ahmad, I., & Nasr, A. (2014) · High Altitude Medicine & Biology · doi:10.1089/ham.2014.1001 · Cited by 11 · see citing works
Hypoxic depression of PKG-mediated inhibition of serotonergic contraction in ovine carotid arteries
Thorpe, R. B., Stockman, S. L., Williams, J. M., Lincoln, T., & Pearce, W. J. (2013) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00212.2012 · Cited by 11 · see citing works
- Authors
- Moore, L. G., Charles, S. M., & Julian, C. G.
- Affiliations
- Wake Forest University Health Sciences (US)
- University of Colorado Denver (US)
- Corresponding author
- Moore, Lorna G.
- Venue
- Respiratory Physiology & Neurobiology
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 178
- Issue
- 1
- Pages
- 181-190
- ISSN
- 1569-9048 (ISSN-L)
- PMC
- PMC3146554
- OpenAlex
- W2009965116
- Cited by
- 251
- References
- 92
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 12 · 2023: 21 · 2022: 13 · 2021: 20 · 2020: 10 · 2019: 11 · 2018: 17 · 2017: 71 · 2016: 6 · 2015: 14 · 2014: 13 · 2013: 13 · 2012: 7
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Respiratory Physiology & Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL-14985, HL079647, R01HL060131, P01HL014985, HL060131, R01HL079647)
- National Institute of Mental Health (R01MH060131)
- Fogarty International Center (TW-001188, R03TW001188)
- 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
- high altitude, chronic hypoxia, fetal growth, uterine artery blood flow, placental oxygen transfer, ischemia-reperfusion injury, placental development, embryonic development, epigenetics
- MeSH terms
- Adaptation, Physiological, Altitude, Female, Fetal Hypoxia, Humans, Oxygen Consumption, Placenta, Pregnancy
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