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Cited by 115High Altitude and HypoxiaPregnancy and preeclampsia studiesBirth, Development, and Health

Where the O2goes to: preservation of human fetal oxygen delivery and consumption at high altitude

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Postigo, Lucrecia, Heredia, Gladys, Illsley, Nicholas P., Torricos, Tatiana, Dolan, Caitlin, Echalar, Lourdes, Tellez, Wilma, Maldonado, Ivan +4 more·2009·The Journal of Physiology
DOI 10.1113/jphysiol.2008.163634PMC PMC2670090
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Abstract

Fetal growth is decreased at high altitude (> 2700 m). We hypothesized that variation in fetal O 2 delivery might account for both the altitude effect and the relative preservation of fetal growth in multigenerational natives to high altitude. Participants were 168 women of European or Andean ancestry living at 3600 m or 400 m. Ancestry was genetically confirmed. Umbilical vein blood flow was measured using ultrasound and Doppler. Cord blood samples permitted calculation of fetal O 2 delivery and consumption. Andean fetuses had greater blood flow and oxygen delivery than Europeans and weighed more at birth, regardless of altitude (+208 g,P< 0.0001). Fetal blood flow was decreased at 3600 m (P< 0.0001); the decrement was similar in both ancestry groups. Altitude‐associated decrease in birth weight was greater in Europeans (−417 g) than Andeans (−228 g,P< 0.005). Birth weight at 3600 m was > 200 g lower for Europeans at any given level of blood flow or O 2 delivery. Fetal haemoglobin concentration was increased,decreased, and the fetal/curve was left‐shifted at 3600 m. Fetuses receiving less O 2 extracted more (r2= 0.35,P< 0.0001). These adaptations resulted in similar fetal O 2 delivery and consumption across all four groups. Increased umbilical venous O 2 delivery correlated with increased fetal O 2 consumption per kg weight (r2= 0.50,P< 0.0001). Blood flow (r2= 0.16,P< 0.001) and O 2 delivery (r2= 0.17,P< 0.001) correlated with birth weight at 3600 m, but not at 400 m (r2= 0.04, and 0.03, respectively). We concluded that the most pronounced difference at high altitude is reduced fetal blood flow, but fetal haematological adaptation and fetal capacity to increase O 2 extraction indicates that deficit in fetal oxygen delivery is unlikely to be causally associated with the altitude‐ and ancestry‐related differences in fetal growth.

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Crossref · 10.1113/jphysiol.2008.163634

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  • At high altitude, there are changes in the vasculature and blood flow on the fetal side of the placenta in both humans and sheep.

    “At high altitude, there are also changes in the vasculature and blood flow on the fetal side of the placenta in both humans and sheep (317, 431, 443).”

    From Placental Origins of Chronic Disease (2016) · cites this paper as [443]

  • 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 [443]

  • In human infants near term, the diameters of the umbilical vein and artery are both smaller at high than low altitude, which results in a lower absolute blood flow in the umbilical circulation, irrespective of ethnicity.

    “In human infants near term, the diameters of the umbilical vein and artery are both smaller at high than low altitude, which results in a lower absolute blood flow in the umbilical circulation, irrespective of ethnicity (295, 443).”

    From Placental Origins of Chronic Disease (2016) · cites this paper as [443]

  • In some studies of Andeans, absolute oxygen delivery to the gravid uterus at high altitude is maintained or even increased above lowland values despite low maternal pO2, while in others the uterine oxygen supply is less at high than low altitude irrespective of ancestry.

    “Thus, in some studies of Andeans, absolute oxygen delivery to the gravid uterus at high altitude is maintained or even increased above lowland values, despite the low maternal pO2, while in others the uterine oxygen supply is less at high than low altitude irrespective of ancestry (69, 295, 443, 604).”

    From Placental Origins of Chronic Disease (2016) · cites this paper as [443]

  • Babies of European ancestry are more adversely affected than those of Andean descent.

    “However, babies of European ancestry are more adversely affected than those of Andean descent (443).”

    From Placental Origins of Chronic Disease (2016) · cites this paper as [443]

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Authors
Postigo, L., Heredia, G., Illsley, N. P., Torricos, T., Dolan, C., Echalar, L., Tellez, W., Maldonado, I., Brimacombe, M., Balanza, E., Vargas, E., & Zamudio, S.
Affiliations
  • Universidad Mayor de San Andrés (BO)
  • Rutgers New Jersey Medical School (US)
ORCID
Venue
The Journal of Physiology
Publisher
Wiley
Published
2009-01-30
Volume
587
Issue
3
Pages
693-708
ISSN
  • 0022-3751 (ISSN-L)
  • 1469-7793
DOI
10.1113/jphysiol.2008.163634
PMC
PMC2670090
OpenAlex
W1943625068
Cited by
115
References
73
Citations by year
2026: 4 · 2025: 8 · 2024: 6 · 2023: 7 · 2022: 5 · 2021: 8 · 2020: 9 · 2019: 7 · 2018: 8 · 2017: 2 · 2016: 7 · 2015: 11 · 2014: 4 · 2013: 11 · 2012: 5
FWCI
2.29
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • The Journal of Physiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD042737, HD 42737)
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
fetal oxygen consumption, high altitude, fetal growth, umbilical venous blood flow, birth weight, fetal hemoglobin, high-altitude adaptation, hypoxia
MeSH terms
Acclimatization, Altitude, Blood Flow Velocity, Blood Gas Analysis, Female, Fetal Blood, Fetal Hemoglobin, Humans, Indians, South American, Infant, Newborn, Oxygen, Pregnancy, Regional Blood Flow, Umbilical Arteries, Umbilical Veins, Vascular Resistance, White People, Fetal Development

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