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Preeclampsia link to gestational hypoxia

Published online by Cambridge University Press:  10 April 2019

W. Tong
Affiliation:
Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK Centre for Trophoblast Research, University of Cambridge, Cambridge, UK Cardiovascular Strategic Research Initiative, University of Cambridge, Cambridge, UK Cambridge Reproductive Strategic Research Initiative, University of Cambridge, Cambridge, UK
D. A. Giussani*
Affiliation:
Department of Physiology Development & Neuroscience, University of Cambridge, Cambridge, UK Centre for Trophoblast Research, University of Cambridge, Cambridge, UK Cardiovascular Strategic Research Initiative, University of Cambridge, Cambridge, UK Cambridge Reproductive Strategic Research Initiative, University of Cambridge, Cambridge, UK
*
Author for correspondence: E-mail: dag26@cam.ac.uk

Abstract

Complications of pregnancy remain key drivers of morbidity and mortality, affecting the health of both the mother and her offspring in the short and long term. There is lack of detailed understanding of the pathways involved in the pathology and pathogenesis of compromised pregnancy, as well as a shortfall of effective prognostic, diagnostic and treatment options. In many complications of pregnancy, such as in preeclampsia, there is an increase in uteroplacental vascular resistance. However, the cause and effect relationship between placental dysfunction and adverse outcomes in the mother and her offspring remains uncertain. In this review, we aim to highlight the value of gestational hypoxia-induced complications of pregnancy in elucidating underlying molecular pathways and in assessing candidate therapeutic options for these complex disorders. Chronic maternal hypoxia not only mimics the placental pathology associated with obstetric syndromes like gestational hypertension at morphological, molecular and functional levels, but also recapitulates key symptoms that occur as maternal and fetal clinical manifestations of these pregnancy disorders. We propose that gestational hypoxia provides a useful model to study the inter-relationship between placental dysfunction and adverse outcomes in the mother and her offspring in a wide array of examples of complicated pregnancy, such as in preeclampsia.

Type
Review
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

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