Increased placental apoptosis in intrauterine growth restriction.
OBJECTIVE
Our purpose was to investigate a possible role for apoptosis in the pathophysiologic mechanisms of intrauterine growth restriction.


METHODS
Placental samples were obtained from 43 uncomplicated third-trimester pregnancies and from 26 pregnancies complicated by intrauterine growth restriction. The definition used to identify cases of intrauterine growth restriction depended on three criteria: clinical evidence of suboptimal growth, ultrasonographic evidence of deviation from an appropriate growth percentile, and individualized birth weight ratios <10th percentile. Light microscopy was used to quantify the incidence of apoptosis. Electron microscopy and TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling) staining were used to confirm the occurrence of apoptosis.


RESULTS
Quantification of apoptosis (medians and interquartile ranges) resulted in the following values: normal third trimester (n = 43) 0.14% of cells (0.08% to 0.20%) and intrauterine growth restriction third trimester (n = 26) 0.24% of cells (0.16% to 0.29%). The incidence of apoptosis was significantly higher in placentas from pregnancies with intrauterine growth restriction compared with normal third-trimester placentas (p < 0.01, Mann Whitney U test).


CONCLUSIONS
These results suggest that apoptosis may play a role in the pathophysiologic mechanisms of intrauterine growth restriction.
Smith
S C
SC
University Department of Obstetrics and Gynecology, University of Nottingham, United Kingdom.
Baker
P N
PN
Symonds
E M
EM
D000328:Adult; D017209:Apoptosis / Q000502:physiology*; D053938:DNA Fragmentation; D005260:Female; D005317:Fetal Growth Retardation / Q000473:pathology*; D005821:Genetic Techniques; D006801:Humans; D008854:Microscopy, Electron; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012016:Reference Values