Increased incidence of placental chorioangioma in high-altitude pregnancies: Hypobaric hypoxia as a possible etiologic factor
Abstract
Objectives Our purpose was to determine the effects of pregnancy at high altitude on the human placental structure.Study design Histologic material from 22 term placentas delivered at altitudes above 3600 m was examined and compared with control material from 760 m.Results Intraplacental chorioangiomas were identified in 5 of the 22 high-altitude placentas but in none of the 59 controls. The lesions were not visible on the external surface of the placentas and were not encapsulated. The state of differentiation varied; some contained numerous capillaries that showed sinusoidal dilations, whereas in others at the opposite extreme mesenchymal cells predominated. The presence of chorioangiomas was frequently associated with threatened premature delivery, a circumvallate placenta, and multiple infarction. The lesions represented only a small percentage of the overall placental volume (<10%).Conclusions The increased incidence of placental chorioangioma observed at high altitude (above 3600 m) may be due to the prevailing hypobaric hypoxia. Overexpression of angiogenic cytokines such as vascular endothelial growth factor, which is known to be up-regulated by this factor in vitro, may mediate this effect.
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An excessive hypoxic response may account for the increased incidence of chorangiomas in placentas from altitudes greater than 4,000 m.
“An excessive hypoxic response may account for the increased incidence of chorangiomas in placentas from altitudes greater than 4,000 m (459, 510), but no data are available as to whether this is HIF-mediated..”
From Placental Origins of Chronic Disease (2016) · cites this paper as [459]
Cites
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Placental Origins of Chronic Disease
Burton, G. J., Fowden, A. L., & Thornburg, K. L. (2016) · Physiological Reviews · doi:10.1152/physrev.00029.2015 · Cited by 717 · see citing works
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- Authors
- Reshetnikova, O. S., Burton, G. J., Milovanov, A. P., & Fokin, E. I.
- Affiliations
- Luhansk State Medical University (UA)
- University of Cambridge (GB)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 1996-02
- Volume
- 174
- Issue
- 2
- Pages
- 557-561
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W1996832201
- Cited by
- 77
- References
- 18
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 9 · 2020: 2 · 2019: 3 · 2018: 4 · 2016: 3 · 2015: 1 · 2013: 4 · 2012: 8
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Gestational Trophoblastic Disease Studies
- Keywords
- placental chorioangioma, high-altitude pregnancy, hypobaric hypoxia, placental histology, threatened preterm labor, circumvallate placenta, placental infarction, vascular endothelial growth factor, angiogenic cytokines, altitude
- MeSH terms
- Adult, Altitude, Female, Hemangioma, Humans, Placenta, Placenta Diseases, Pregnancy
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