Peyter A-C, Delhaes F, Baud D, Vial Y, Diaceri G, Menétrey S, Hohlfeld P, Tolsa J-F
Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Neonatal Research Laboratory, Clinic of Neonatology, Department of Pediatrics, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Placenta. 2014 Nov;35(11):891-9. doi: 10.1016/j.placenta.2014.08.090. Epub 2014 Sep 2.
Intrauterine growth restriction (IUGR) affects ∼8% of all pregnancies and is associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiovascular diseases in adulthood. Despite identification of several risk factors, the mechanisms implicated in the development of IUGR remain poorly understood. In case of placental insufficiency, reduced delivery of oxygen and/or nutrients to the fetus could be associated with alterations in the umbilical circulation, contributing further to the impairment of maternal-fetal exchanges. We compared the structural and functional properties of umbilical cords from growth-restricted and appropriate for gestational age (AGA) term newborns, with particular attention to the umbilical vein (UV).
Human umbilical cords were collected at delivery. Morphological changes were investigated by histomorphometry, and UV's reactivity by pharmacological studies.
Growth-restricted newborns displayed significantly lower growth parameters, placental weight and umbilical cord diameter than AGA controls. Total cross-section and smooth muscle areas were significantly smaller in UV of growth-restricted neonates than in controls. Maximal vasoconstriction achieved in isolated UV was lower in growth-restricted boys than in controls, whereas nitric oxide-induced relaxation was significantly reduced in UV of growth-restricted girls compared to controls.
IUGR is associated with structural alterations of the UV in both genders, and with a decreased nitric oxide-induced relaxation in UV of newborn girls, whereas boys display impaired vasoconstriction. Further investigations will allow to better understand the regulation of umbilical circulation in growth-restricted neonates, which could contribute to devise potential novel therapeutic strategies to prevent or limit the development of IUGR.
胎儿宫内生长受限（IUGR）影响约8%的所有妊娠，与围产期主要死亡率和发病率相关，并且成年后患心血管疾病的风险增加。尽管已确定了多种风险因素，但IUGR发生发展所涉及的机制仍知之甚少。在胎盘功能不全的情况下，向胎儿输送的氧气和/或营养物质减少可能与脐循环改变有关，进一步导致母胎交换受损。我们比较了生长受限和适于胎龄（AGA）足月新生儿脐带的结构和功能特性，特别关注脐静脉（UV）。
在分娩时收集人脐带。通过组织形态计量学研究形态学变化，并通过药理学研究评估UV的反应性。
生长受限新生儿的生长参数、胎盘重量和脐带直径显著低于AGA对照组。生长受限新生儿的UV总横截面积和平滑肌面积显著小于对照组。生长受限男孩的离体UV中达到的最大血管收缩低于对照组，而与对照组相比，生长受限女孩的UV中一氧化氮诱导的舒张显著降低。
IUGR与男女两性的UV结构改变相关，并且与新生女孩UV中一氧化氮诱导的舒张降低有关，而男孩表现出血管收缩受损。进一步的研究将有助于更好地理解生长受限新生儿脐循环的调节，这可能有助于设计潜在的新治疗策略来预防或限制IUGR的发生发展。
