Peeters L L, Verkeste C M, Wallenburg H C, Saxena P R, van Kreel B K
Department of Obstetrics and Gynecology, Erasmus University Medical School, Rotterdam, The Netherlands.
Pediatr Res. 1989 Jun;25(6):641-4. doi: 10.1203/00006450-198906000-00017.
Our study in pregnant guinea pigs was designed to determine whether the modest fractional contribution of glucose to the late-pregnant uterine caloric uptake was due to inadequate uterine glucose supply or to diminished uterine glucose demand. To this end, uterine uptake of glucose, O2, and lactate was measured in 27 late-pregnant guinea pigs with a wide range of litter sizes. A group of 11 mid-pregnant guinea pigs served as a reference. The fractional uterine uptake of glucose in mid- and late-pregnancy was 90 and 45%, respectively, confirming the indirect data calculated from different studies. In late pregnancy, uteroplacental blood flow (microspheres, -40%) as well as arterial glucose concentration (-30%) had decreased relative to mid-gestation, giving rise to a 60% lower wt-specific uterine glucose supply and a 21% lower wt-specific uterine glucose uptake. Inasmuch as fetal and placental glycogen stores become rapidly depleted after the 50th day of pregnancy, the lower uterine glucose uptake in late pregnancy appears to reflect inadequate uterine glucose supply rather than diminished fetal glucose demands. In late pregnancy, uterine caloric demand per kg is about 60% more than in mid-gestation, most likely associated with accelerated fetal fat accretion. Inasmuch as the latter appears to be mostly fueled by nonglucose fat precursors, it could explain why the glucose fraction of the uterine caloric uptake in late pregnancy has decreased by 50% instead of 21% as compared to mid-gestation. The reduction in arterial glucose concentration in late pregnancy was independent of litter size suggesting this phenomenon is to be a maturational adaptation rather than a sign of inadequate maternal glucose production.
我们在妊娠豚鼠身上进行的研究旨在确定,葡萄糖对妊娠晚期子宫热量摄取的适度贡献率较低,是由于子宫葡萄糖供应不足,还是子宫葡萄糖需求减少所致。为此,我们测量了27只妊娠晚期、窝仔数范围广泛的豚鼠子宫对葡萄糖、氧气和乳酸的摄取量。一组11只妊娠中期的豚鼠作为对照。妊娠中期和晚期子宫对葡萄糖的摄取率分别为90%和45%,这证实了从不同研究中计算得出的间接数据。在妊娠晚期,相对于妊娠中期,子宫胎盘血流量(微球法,降低40%)以及动脉葡萄糖浓度(降低30%)均有所下降,导致单位体重的子宫葡萄糖供应量降低60%,单位体重的子宫葡萄糖摄取量降低21%。由于妊娠50天后胎儿和胎盘糖原储备迅速耗尽,妊娠晚期子宫葡萄糖摄取量较低似乎反映了子宫葡萄糖供应不足,而非胎儿葡萄糖需求减少。在妊娠晚期,每千克子宫的热量需求比妊娠中期约高60%,这很可能与胎儿脂肪堆积加速有关。由于后者似乎主要由非葡萄糖脂肪前体提供能量,这可以解释为什么与妊娠中期相比,妊娠晚期子宫热量摄取中的葡萄糖比例下降了50%,而非21%。妊娠晚期动脉葡萄糖浓度的降低与窝仔数无关,这表明这种现象是一种成熟适应,而非母体葡萄糖生成不足的迹象。