Maternal adaptation to high-altitude pregnancy: An experiment of nature - A review

Lorna G. Moore, M. Shriver, L. Bemis, B. Hickler, M. Wilson, T. Brutsaert, E. Parra, E. Vargas

Research output: Contribution to journalArticle

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Abstract

A long and productive history of studies at high altitude has demonstrated that chronic hypoxia plays a key role in the aetiology of intrauterine growth restriction (IUGR) and pre-eclampsia. Susceptibility to altitude-associated IUGR varies among high-altitude populations in relation to their duration of altitude exposure, with multigenerational residents demonstrating one-third the birth weight fall present in shorter-resident groups. Higher uteroplacental blood flow during pregnancy in multigenerational high-altitude residents suggests that such population differences are due, at least in part, to differences in maternal vascular responses to pregnancy. We hypothesize that natural selection acting on hypoxia-inducible factor (HIF)-targeted or -regulatory genes has enabled maternal vascular adaptation to pregnancy in long-resident high-altitude groups. Preliminary evidence in support of this hypothesis demonstrates that the potent HIF-targeted vasoconstrictor, endothelin-1 (ET-1), is differentially regulated by pregnancy and chronic hypoxia in Andean vs European residents of high altitude. Andeans show the normal, pregnancy-associated fall in ET-1 levels previously reported at low altitude, whereas Europeans have higher ET-1 levels and little pregnancy-associated change, like pre-eclamptic women. Single nucleotide polymorphisms (SNPs) in the ET-1 gene also differ in Andeans compared with low-altitude populations. We conclude that high altitude serves as an experiment of nature for elucidating genetic factors underlying susceptibility to complications of pregnancy and fetal life. Such studies may be important for identifying persons at risk for these complications at any altitude.

Original languageEnglish (US)
JournalPlacenta
Volume25
Issue numberSUPPL. A
DOIs
StatePublished - Jan 1 2004

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Mothers
Pregnancy
Endothelin-1
Blood Vessels
Population
Pregnancy Complications
Genetic Selection
Vasoconstrictor Agents
Regulator Genes
Growth
Pre-Eclampsia
Birth Weight
Single Nucleotide Polymorphism
Hypoxia
Genes

Cite this

Moore, L. G., Shriver, M., Bemis, L., Hickler, B., Wilson, M., Brutsaert, T., ... Vargas, E. (2004). Maternal adaptation to high-altitude pregnancy: An experiment of nature - A review. Placenta, 25(SUPPL. A). https://doi.org/10.1016/j.placenta.2004.01.008

Maternal adaptation to high-altitude pregnancy : An experiment of nature - A review. / Moore, Lorna G.; Shriver, M.; Bemis, L.; Hickler, B.; Wilson, M.; Brutsaert, T.; Parra, E.; Vargas, E.

In: Placenta, Vol. 25, No. SUPPL. A, 01.01.2004.

Research output: Contribution to journalArticle

Moore, LG, Shriver, M, Bemis, L, Hickler, B, Wilson, M, Brutsaert, T, Parra, E & Vargas, E 2004, 'Maternal adaptation to high-altitude pregnancy: An experiment of nature - A review', Placenta, vol. 25, no. SUPPL. A. https://doi.org/10.1016/j.placenta.2004.01.008
Moore, Lorna G. ; Shriver, M. ; Bemis, L. ; Hickler, B. ; Wilson, M. ; Brutsaert, T. ; Parra, E. ; Vargas, E. / Maternal adaptation to high-altitude pregnancy : An experiment of nature - A review. In: Placenta. 2004 ; Vol. 25, No. SUPPL. A.
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