Greater uterine artery blood flow during pregnancy in multigenerational (Andean) than shorter-term (European) high-altitude residents
Abstract
Multigenerational (Andean) compared with shorter-term (European) high-altitude residents exhibit less hypoxia-associated reductions in birth weight. Because differences in arterial O 2 content are not responsible, we asked whether greater pregnancy-associated increases in uterine artery (UA) blood flow and O 2 delivery were involved. Serial studies were conducted in 42 Andean and 26 European residents of La Paz, Bolivia (3600 m) at weeks 20, 30, 36 of pregnancy and 4 mo postpartum using Doppler ultrasound. There were no differences postpartum but Andean vs. European women had greater UA diameter (0.65 ± 0.01 vs. 0.56 ± 0.01 cm), cross-sectional area (33.1 ± 0.97 vs. 24.7 ± 1.18 mm 2), and blood flow at week 36 (743 ± 87 vs. 474 ± 36 ml/min) (all P < 0.05) and thus 1.6-fold greater uteroplacental O 2 delivery near term (126.82 ± 18.47 vs. 80.33 ± 8.69 ml O 2·ml blood−1·min−1, P < 0.05). Andeans had greater common iliac (CI) flow and lower external iliac relative to CI flow (0.52 ± 0.11 vs. 0.95 ± 0.14, P < 0.05) than Europeans at week 36. After adjusting for gestational age, maternal height, and parity, Andean babies weighed 209 g more than the Europeans. Greater UA cross-sectional area at week 30 related positively to birth weight in Andeans ( r = +0.39) but negatively in Europeans ( r = −0.37) (both P < 0.01). We concluded that a greater pregnancy-associated increase in UA diameter raised UA blood flow and uteroplacental O 2 delivery in the Andeans and contributed to their ability to maintain normal fetal growth under conditions of high-altitude hypoxia. These data implicate the involvement of genetic factors in protecting multigenerational populations from hypoxia-associated reductions in fetal growth, but future studies are required for confirmation and identification of the specific genes involved.
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In the majority of studies, the normal pregnancy-induced rise in uterine blood flow is blunted at high altitude in association with a reduced diameter of the uterine arteries and/or lower nitric oxide synthesis, regardless of ancestry.
“However, in the majority of studies, the normal pregnancy-induced rise in uterine blood flow is blunted at high altitude in association with a reduced diameter of the uterine arteries and/or lower nitric oxide synthesis, regardless of ancestry (294, 295, 577, 603, 604).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [577]
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- Authors
- Wilson, M. J., Lopez, M., Vargas, M., Julian, C., Tellez, W., Rodriguez, A., Bigham, A., Armaza, J. F., Niermeyer, S., Shriver, M., Vargas, E., & Moore, L. G.
- Affiliations
- University of Colorado Denver (US)
- Universidad Mayor de San Andrés (BO)
- Pennsylvania State University (US)
- Venue
- American Journal of Physiology-Regulatory, Integrative and Comparative Physiology
- Publisher
- American Physiological Society
- Published
- 2007-09
- Volume
- 293
- Issue
- 3
- Pages
- R1313-R1324
- ISSN
- 0363-6119 (ISSN-L)
- 1522-1490
- OpenAlex
- W2170781977
- Cited by
- 101
- References
- 49
- Citations by year
- 2025: 7 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 9 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 10 · 2012: 6
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Regulatory, Integrative and Comparative Physiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (TN01188)
- National Heart, Lung, and Blood Institute (HL-07171, R01HL060131, HL60131, T32HL007171)
- 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
- uterine artery blood flow, high-altitude adaptation, fetal growth, birth weight, hypoxia, uteroplacental circulation, genetic adaptation, pregnancy, Doppler ultrasound, fetal growth restriction, La Paz, Bolivia
- MeSH terms
- Adult, Altitude, Biometry, Birth Weight, Blood Volume, Bolivia, Europe, Female, Fetal Hypoxia, Humans, Indians, South American, Infant, Newborn, Pregnancy, Regional Blood Flow, Uterus, Vascular Resistance, Lower Extremity, Delivery, Obstetric, Fetal Development
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