Document Detail


Where the O2 goes to: preservation of human fetal oxygen delivery and consumption at high altitude.
MedLine Citation:
PMID:  19074967     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (r(2) = 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 (r(2) = 0.50, P < 0.0001). Blood flow (r(2) = 0.16, P < 0.001) and O(2) delivery (r(2) = 0.17, P < 0.001) correlated with birth weight at 3600 m, but not at 400 m (r(2) = 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.
Authors:
Lucrecia Postigo; Gladys Heredia; Nicholas P Illsley; Tatiana Torricos; Caitlin Dolan; Lourdes Echalar; Wilma Tellez; Ivan Maldonado; Michael Brimacombe; Elfride Balanza; Enrique Vargas; Stacy Zamudio
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2008-12-15
Journal Detail:
Title:  The Journal of physiology     Volume:  587     ISSN:  1469-7793     ISO Abbreviation:  J. Physiol. (Lond.)     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-05-06     Revised Date:  2013-06-04    
Medline Journal Info:
Nlm Unique ID:  0266262     Medline TA:  J Physiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  693-708     Citation Subset:  IM    
Affiliation:
Hospital Materno-Infantil, Universidad de San Andreas Mayor, La Paz, Bolivia.
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MeSH Terms
Descriptor/Qualifier:
Acclimatization*
Altitude*
Blood Flow Velocity
Blood Gas Analysis
European Continental Ancestry Group
Female
Fetal Blood*
Fetal Development / physiology*
Fetal Hemoglobin / analysis
Humans
Indians, South American
Infant, Newborn
Oxygen* / blood
Pregnancy
Regional Blood Flow / physiology
Umbilical Arteries / anatomy & histology,  physiology
Umbilical Veins / anatomy & histology,  physiology
Vascular Resistance
Grant Support
ID/Acronym/Agency:
HD 42737/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen; 9034-63-3/Fetal Hemoglobin
Comments/Corrections

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