Biological features of placental programming.
The placenta is a key organ in programming the fetus for later disease. This review outlines nine of many structural and physiological features of the placenta which are associated with adult onset chronic disease. 1) Placental efficiency relates the placental mass to the fetal mass. Ratios at the extremes are related to cardiovascular disease risk later in life. 2) Placental shape predicts a large number of disease outcomes in adults but the regulators of placental shape are not known. 3) Non-human primate studies suggest that at about mid-gestation, the placenta becomes less plastic and less able to compensate for pathological stresses. 4) Recent studies suggest that lipids have an important role in regulating placental metabolism and thus the future health of offspring. 5) Placental inflammation affects nutrient transport to the fetus and programs for later disease. 6) Placental insufficiency leads to inadequate fetal growth and elevated risks for later life disease. 7) Maternal height, fat and muscle mass are important in combination with placental size and shape in predicting adult disease. 8) The placenta makes a host of hormones that influence fetal growth and are related to offspring disease. Unfortunately, our knowledge of placental growth and function lags far behind that of other organs. An investment in understanding placental growth and function will yield enormous benefits to human health because it is a key player in the origins of the most expensive and deadly chronic diseases that humans face.
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA; Department of Medicine, Oregon Health and Science University, Portland, OR, USA; Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA; Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, OR, USA. Electronic address: thornbur@ohsu.edu.
Kent L
KL
Thornburg
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR, USA.
Kevin
K
Kolahi
Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA.
Melinda
M
Pierce
Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA.
Amy
A
Valent
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA.
Rachel
R
Drake
Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA; Moore Institute for Nutrition and Wellness, Oregon Health and Science University, Portland, OR, USA.
Samantha
S
Louey
D000818:Animals; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D008431:Maternal-Fetal Exchange / Q000502:physiology*; D010920:Placenta / Q000502:physiology*; D010927:Placental Insufficiency / Q000503:physiopathology; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology
Birthweight; Chronic disease; Inflammation; Placenta; Programming; Trophoblast