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Scientists can predict which women will have serious pregnancy complications

Anonymous — Tue, 08 Jun 2021 16:01:04 +0000

Nearly all of the organ systems of the mother’s body need to alter their function during pregnancy so that the baby can grow. If the mother’s body cannot properly adapt to the growing baby this leads to major and common issues including fetal growth restriction, fetal over-growth, gestational diabetes, and preeclampsia – a life-threatening high blood pressure in the mother.

Many of these complications lead to difficult labours for women with more medical intervention and lifelong issues for the baby including diabetes, heart issues and obesity.

Pregnancy disorders affect around one in ten pregnant women, but current methods to diagnose them are not sensitive or reliable enough to identify all at-risk pregnancies.

Now scientists have found a way to test hormone levels in the placenta to predict which women will have serious pregnancy complications. Their study is published today in the journal Nature Communications Biology.

“We found that hormonal biomarkers from the placenta could indicate which women would have pregnancy complications,” said Dr Amanda Sferruzzi-Perri in the ̽��ֱ�� of Cambridge’s Department of Physiology, Development and Neuroscience, who led the study.

She added: “We found that these hormonal biomarkers are present from the first trimester of pregnancy. This is a highly important finding given that pregnancy disorders affect around one in ten pregnant women and are often diagnosed too late, when the complications are already wreaking havoc on the mother’s body and the fetal development.”

Using mouse models, researchers looked at the proteins made by the placenta and compared them to blood samples from women who had uneventful pregnancies and those who developed gestational diabetes. ̽��ֱ��team developed new methods to isolate and study the endocrine cells in the mouse placenta because these cells are responsible for secreting hormones during pregnancy.

They profiled the placenta to identify the hormones that are secreted to create a comprehensive map of proteins in the mysterious organ. ̽��ֱ��mouse model map of hormonal proteins from the placenta was then compared with datasets from studies of the human placenta and pregnancy outcomes and researchers discovered a lot of biological overlap.

Dr Sferruzzi-Perri said: “We found that around a third of the proteins we identified changed in women during pregnancies with disorders. Using a small study to test if these placental proteins will have some clinical value, we also discovered that abnormal levels of hormones were present in the mother’s blood as early as the first trimester – week 12 of gestation – in women who developed gestational diabetes, a pregnancy complication usually diagnosed at 24-28 weeks.

“We also identified several specific transcription factors – proteins within the cell that turn on or off genes – that are likely to govern the production of placental hormones which have important implications for understanding how we may improve pregnancy outcomes.”

̽��ֱ��scientists explored whether these genetic biomarkers were detectable during pregnancy and used a study that tracked pregnancy outcomes in women at Addenbrooke’s Hospital in Cambridge. They found that blood samples showed these biomarkers in early pregnancy which could lead to earlier diagnosis of complications allowing treatment to begin more quickly.

Dr Claire Meek, a diabetes in pregnancy physician and researcher at Addenbrooke’s, said: “This pregnancy-induced form of diabetes causes accelerated growth of the baby and complications at the time of delivery. Unfortunately, some women already have signs of a big baby at the time of diagnosis at 28 weeks. This new test might be able to identify gestational diabetes earlier in pregnancy, providing opportunities to prevent the disease, or to protect mums and babies from the most harmful complications.”

Dr Sferruzzi-Perri said: “This work provides new hope that a better understanding of the placenta will result in safer, healthier pregnancies for mothers and babies. Our team is now working to assess whether these discoveries could improve clinical care in future, either through earlier diagnosis or to provide new opportunities to treat these pregnancy complications by targeting the placenta.”

̽��ֱ��placenta is a complex biological organ. It forms and grows from the fertilised egg, and attaches to the wall of the uterus. It allows nutrients and oxygen to flow from mother to baby, and removes fetal waste products. Despite its importance, the placenta is a very misunderstood organ and is notoriously difficult to study in pregnant women. But its ability to function properly is vital as it impacts on pregnancy outcomes and the lifelong health of mother and child.

̽��ֱ��placenta develops during pregnancy and connects the developing baby to the mother. It serves as the lungs, kidneys, gut and liver for growing babies and carries oxygen and nutrients to the fetus whilst secreting hormones and discarding waste.

Reference

Napso, T. et al. Placental secretome characterization identified candidates for pregnancy complications. Nature Communications Biology, June 2021. DOI: https://doi.org/10.1038/s42003-021-02214-x

Adapted from a press release by St John's College, Cambridge

Women who will develop potentially life-threatening disorders during pregnancy can be identified early when hormone levels in the placenta are tested, a new study has shown.

This work provides new hope that a better understanding of the placenta will result in safer, healthier pregnancies for mothers and babies.

Amanda Sferruzzi-Perri

Fishman64 at Shutterstock.com

Pregnancy scan

̽��ֱ��text in this work is licensed under a Creative Commons Attribution 4.0 International License. Images, including our videos, are Copyright © ̽��ֱ�� of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – as here, on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Placenta changes could mean male offspring of older mums more likely to develop heart problems in later life, rat study finds

jg533 — Thu, 28 Nov 2019 10:51:48 +0000

Both male and female fetuses do not grow as large in older mothers, but there are sex-specific differences in changes to placental development and function. These are likely to play a central role in the increased likelihood of later-life heart problems and high blood pressure in males.

In humans, women over 35 are considered to be of advanced maternal age. ̽��ֱ��study, published in Scientific Reports, looked at pregnant rats of a comparable age. In aged mothers, the placenta of female fetuses showed beneficial changes in structure and function that would maximise the support of fetal growth. In some instances, the placenta even supported the female fetus better than the placenta of a younger mother. In the case of male fetuses however, the placenta showed changes that would limit fetal growth in the aged pregnant rats.

“This new understanding of placental development and function could contribute to better management of human pregnancies, and development of targeted interventions to improve the longer-term health of children born to older mothers,” said Dr Tina Napso, a postdoctoral fellow at the ̽��ֱ�� of Cambridge and first author of the study.

Pregnancy in older mothers is associated with a heightened risk of complications for both the mother and her baby. These include preeclampsia - raised blood pressure in the mother during pregnancy, gestational diabetes, stillbirth and fetal growth restriction. Until now there has been limited understanding of how the placenta is altered by advanced maternal age.

“With the average age of first pregnancy in women becoming higher and higher, and especially so in developed countries, it is very important to understand how the age of the mother and the sex of the baby interact to determine pregnancy and later-life health of the child,” said Dr Amanda Sferruzzi-Perri, lead author of the study and a Royal Society Fellow in the Centre for Trophoblast Research at the ̽��ֱ�� of Cambridge’s Department of Physiology, Development and Neuroscience.

̽��ֱ��placenta transports nutrients and oxygen from mother to fetus, secretes signalling factors into the mother so she supports fetal development, and is the main protective barrier for the fetus against toxins, bacteria, and hormones - such as stress hormones - in the mother’s blood. It is highly dynamic in nature, and its function can change to help protect the growing fetus when conditions become less favourable for its development, for example through a lack of nutrients or oxygen or when the mother is stressed.

̽��ֱ��researchers analysed the placentas of young (3-4 months old) and aged rats (9.5-10 months old) that were pregnant with male and female offspring. ̽��ֱ��aged rats correspond to approximately 35 year-old humans. Rats are a useful model as their biology and physiology have a number of important characteristics in common with those of humans.

̽��ֱ��study found that advanced maternal age reduced the efficiency of the placenta of both male and female fetuses. It affected the structure and function of the placenta more markedly for male fetuses, reducing its ability to support growth of the fetus.

“A pregnancy at an older age is a costly proposition for the mother, whose body has to decide how nutrients are shared with the fetus. That’s why, overall, fetuses do not grow sufficiently during pregnancy when the mother is older compared to when she is young,” said Dr Napso. “We now know that growth, as well as gene expression in the placenta is affected in older mothers in a manner that partially depends on sex: changes in the placentas of male fetuses are generally detrimental.”

̽��ֱ��research involved a collaboration between scientists at the ̽��ֱ�� of Cambridge, the ̽��ֱ�� of Alberta in Canada, the Robinson Research Institute and the ̽��ֱ�� of Adelaide, Australia.

An earlier study performed by the collaborators showed that offspring from mothers who enter pregnancy at an older age have poor heart function and high blood pressure as young adults, and particularly so if they are male. This new research was conducted to understand why, and whether this sex difference may be due to how the male and female fetuses are supported within the womb in an aged mother.

Although further studies in humans are required, the results suggest the importance of considering the sex of the fetus when giving advice to older pregnant women. ̽��ֱ��researchers also hope to build on these results and find ways of improving the function of the placenta to optimise growth of the fetus.

Reference
Napso, T. et al: “Advanced maternal age compromises fetal growth and induces sex-specific changes in placental phenotype in rates.” Scientific Reports (2019). DOI:10.1038/s41598-019-53199-x

Changes occur in the placenta in older pregnant mothers leading to a greater likelihood of poor health in their male offspring, a study in rats has shown.

With the average age of first pregnancy in women becoming higher and higher, especially in developed countries, it is very important to understand how the age of the mother and the sex of the baby interact to determine pregnancy and later-life health of the child.

Amanda Sferruzzi-Perri

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