Robinson Institute, Department of Paediatrics and Reproductive Health, Faculty of Health Sciences, Medical North, Level 6, Frome Road, University of Adelaide, Adelaide, SA 5005, Australia.
Placenta. 2010 Mar;31 Suppl:S33-9. doi: 10.1016/j.placenta.2009.11.010. Epub 2009 Dec 11.
There are known sex specific differences in fetal and neonatal morbidity and mortality. There are also known differences in birthweight centile with males generally being larger than females at birth. These differences are generally ignored when studying obstetric complications of pregnancy and the mechanisms that confer these differences between the sexes are unknown. Current evidence suggests sex specific adaptation of the placenta may be central to the differences in fetal growth and survival. Our research examining pregnancies complicated by asthma has reported sexually dimorphic differences in fetal growth and survival with males adapting placental function to allow for continued growth in an adverse maternal environment while females reduce growth in an attempt to survive further maternal insults. We have reported sex differences in placental cytokine expression, insulin-like growth factor pathways and the placental response to cortisol in relation to the complication of asthma during pregnancy. More recently we have identified sex specific alterations in placental function in pregnancies complicated by preterm delivery which were associated with neonatal outcome and survival. We propose the sexually dimorphic differences in growth and survival of the fetus are mediated by the sex specific function of the human placenta. This review will present evidence supporting this hypothesis and will argue that to ignore the sex of the placenta is no longer sound scientific practice.
胎儿和新生儿的发病率和死亡率存在已知的性别特异性差异。出生体重百分位数也存在差异，一般来说，男性出生时比女性大。在研究妊娠的产科并发症及其导致这些性别的差异的机制时，这些差异通常被忽视。目前的证据表明，胎盘的性别特异性适应可能是胎儿生长和存活差异的核心。我们研究哮喘合并妊娠的结果报告了胎儿生长和存活的性别二态性差异，男性通过胎盘功能的适应性来允许在不利的母体环境中继续生长，而女性则减少生长，以试图进一步免受母体的伤害。我们报告了与妊娠期间哮喘并发症相关的胎盘细胞因子表达、胰岛素样生长因子途径和胎盘对皮质醇反应的性别差异。最近，我们发现早产合并妊娠的胎盘功能存在性别特异性改变，与新生儿结局和存活有关。我们提出，胎儿生长和存活的性别二态性差异是由人类胎盘的性别特异性功能介导的。这篇综述将提供支持这一假设的证据，并认为忽视胎盘的性别不再是合理的科学实践。
