Document Detail


Lower uterine artery blood flow and higher endothelin relative to nitric oxide metabolite levels are associated with reductions in birth weight at high altitude.
MedLine Citation:
PMID:  18579652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Reduced uteroplacental blood flow is hypothesized to play a key role in altitude-associated fetal growth restriction. It is unknown whether reduced blood flow is a cause or consequence of reduced fetal size. We asked whether determinants of uteroplacental blood flow were altered prior to reduced fetal growth and whether vasoactive and/or angiogenic factors were involved. Women residing at low (LA; 1,600 m, n = 18) or high altitude (HA; 3,100 m, n = 25) were studied during pregnancy (20, 30, and 36 wk) and 4 mo postpartum (PP) using Doppler ultrasound. In each study, endothelin (ET-1), nitric oxide metabolites (NO(x)), soluble fms-like tyrosine kinase (sFlt-1) and placental growth factor (PlGF) levels were quantified. At HA, birth weights were lower (P < 0.01) and small-for-gestational age was more common (P < 0.05) compared with LA. HA was associated with lower uterine artery (UA) diameter (P < 0.01) and blood flow (P < 0.05). Altitude did not affect ET-1, sFlt-1 or PlGF; however, ET-1/NO(x) was greater and NO(x) lower during pregnancy and PP at HA vs. LA. ET-1/NO(x) was negatively associated with birth weight (20 wk, P < 0.01; 36 wk, P = 0.05) at LA and HA combined. At HA, UA blood flow (30 wk) was positively associated with birth weight (dagger). UA blood flow and ET-1/NO(x) levels accounted for 45% (20 wk) and 32% (30 wk) of birth weight variation at LA and HA combined, primarily attributed to effects at HA. We concluded that elevated ET-1/NO(x) and altered determinants of uteroplacental blood flow occur prior to altitude-associated reductions in fetal growth, and therefore, they are likely a cause rather than a consequence of smaller fetal size.
Authors:
Colleen Glyde Julian; Henry L Galan; Megan J Wilson; Wendy Desilva; Darleen Cioffi-Ragan; Joel Schwartz; Lorna G Moore
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-06-25
Journal Detail:
Title:  American journal of physiology. Regulatory, integrative and comparative physiology     Volume:  295     ISSN:  0363-6119     ISO Abbreviation:  Am. J. Physiol. Regul. Integr. Comp. Physiol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-08     Completed Date:  2008-10-17     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  100901230     Medline TA:  Am J Physiol Regul Integr Comp Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  R906-15     Citation Subset:  IM    
Affiliation:
Altitude Research Center, Dept. of Surgery, Division of Emergency Medicine, Univ. of Colorado Denver, 12469 East 17th Place, Bldg. 400, Aurora, Colorado 80045, USA. colleen.julian@uchsc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Altitude*
Birth Weight / physiology*
Colorado
Endothelin-1 / metabolism*
Female
Femur / anatomy & histology
Fetal Growth Retardation / metabolism*,  physiopathology
Head / anatomy & histology
Humans
Infant, Newborn
Infant, Small for Gestational Age
Nitric Oxide / metabolism*
Oxygen / metabolism
Pregnancy
Regression Analysis
Uterus / blood supply*,  metabolism*
Grant Support
ID/Acronym/Agency:
HL-060131/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Endothelin-1; 10102-43-9/Nitric Oxide; 7782-44-7/Oxygen
Comments/Corrections

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