Maternal Adaptation in Physiological and Pathological Pregnancy

A special issue of Biology (ISSN 2079-7737). This special issue belongs to the section "Reproductive Biology".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 7480

Special Issue Editors

Department of Obstetrics and Gynecology, University of Auckland, Auckland 1010, New Zealand
Interests: placenta; pregnancy; preeclampsia; endothelial cells; extracellular vesicles; gynaecological cancer; ovarian cancer; endometrial cancer
The Hospital of Obstetrics & Gynaecology, Fudan University, Shanghai 200081, China
Interests: pregnancy; complicated pregnancies; placenta; extracellular vesicles

Special Issue Information

Dear Colleagues,

To achieve a successful pregnancy without damaging maternal health, a number of maternal adaptative changes are developed in response to an induced reset of various cardiovascular and immune regulatory receptors. These natural changes include increased cardiac output, expanded blood volume, and reduced systemic vascular resistance, blood pressure and immune tolerance. The importance of these adaptive changes is clear as the failure of maternal adaptation could result in developing a number of complicated pregnancies, including preeclampsia, miscarriage, and foetal growth restriction. However, it is obvious that our current insights into normal and defective adaptation to pregnancy are still incomplete, and the triggers for this re-setting are largely unknown. Current increasing evidence suggests that the placenta plays an important role in participating in the process of maternal adaptation in early stage. This is because preeclampsia and foetal growth restructure are collectively referred to as placental dysfunction or placental syndrome. Better understanding maternal adaptation between the physiological and pathological conditions in the first trimester pregnancy can pave the way for the development of strategies for early intervention and prevention if needed.

Purpose of the special issue:

To better understand the mechanisms underlying how maternal adaptation develops.

Focus:

This Special Issue will focus on (1) how the placenta contributes to maternal adaptation in physiological conditions, (2) how mothers respond to triggers from the placenta in physiological and pathological conditions.

Scope:

All topics, including but not limited to placentation, placental metabolism, placental development, placental pathology, the clinical aspect of maternal cardiovascular changes, and the assessment of biomarkers of placental disorders.

Dr. Qi Chen
Dr. Yunhui Tang
Guest Editors

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Keywords

  • pregnancy
  • maternal adaptation
  • placenta
  • cardiovascular system
  • immune system
  • complications of pregnancy

Published Papers (5 papers)

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Research

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15 pages, 1409 KiB  
Article
Maternal Cardiovascular Responses to Position Change in Pregnancy
by Alys R. Clark, Hanna Fontinha, John Thompson, Sophie Couper, Devanshi Jani, Ali Mirjalili, Laura Bennet and Peter Stone
Biology 2023, 12(9), 1268; https://doi.org/10.3390/biology12091268 - 21 Sep 2023
Viewed by 1118
Abstract
The maternal cardiovascular-circulatory system undergoes profound changes almost from the conception of a pregnancy until the postpartum period to support the maternal adaptions required for pregnancy and lactation. Maintenance of cardiovascular homeostasis requires changes in the cardiovascular autonomic responses. Here, we present a [...] Read more.
The maternal cardiovascular-circulatory system undergoes profound changes almost from the conception of a pregnancy until the postpartum period to support the maternal adaptions required for pregnancy and lactation. Maintenance of cardiovascular homeostasis requires changes in the cardiovascular autonomic responses. Here, we present a longitudinal study of the maternal cardiovascular autonomic responses to pregnancy and maternal position. Over a normal gestation, in the left lateral position there are significant changes in both time and frequency domain parameters reflecting heart rate variability. We show that cardiovascular autonomic responses to physiological stressors (standing and supine positions in late pregnancy) became significantly different with advancing gestation. In the third trimester, 60% of the subjects had an unstable heart rate response on standing, and these subjects had a significantly reduced sample entropy evident in their heart rate variability data. By 6 weeks, postpartum function returned to near the non-pregnant state, but there were consistent differences in high-frequency power when compared to nulligravid cases. Finally, we review complementary evidence, in particular from magnetic resonance imaging, that provides insights into the maternal and fetal impacts of positioning in pregnancy. This demonstrates a clear relationship between supine position and maternal hemodynamic parameters, which relates to compression of the inferior vena cava (p = 0.05). Together, these studies demonstrate new understanding of the physiology of physiological stressors related to position. Full article
(This article belongs to the Special Issue Maternal Adaptation in Physiological and Pathological Pregnancy)
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12 pages, 3698 KiB  
Article
A Novel Dual-Function Redox Modulator Relieves Oxidative Stress and Anti-Angiogenic Response in Placental Villus Explant Exposed to Hypoxia—Relevance for Preeclampsia Therapy
by Diana Pintye, Réka E. Sziva, Maxim Mastyugin, Brett C. Young, Sonako Jacas, Marianna Török, Saira Salahuddin, Prakash Jagtap, Garry J. Southan and Zsuzsanna K. Zsengellér
Biology 2023, 12(9), 1229; https://doi.org/10.3390/biology12091229 - 12 Sep 2023
Cited by 1 | Viewed by 896
Abstract
Background: Preeclampsia (PE) is a severe, life-threatening complication during pregnancy (~5–7%), and no causative treatment is available. Early aberrant spiral artery remodeling is associated with placental stress and the release of oxygen radicals and other reactive oxygen species (ROS) in the placenta. This [...] Read more.
Background: Preeclampsia (PE) is a severe, life-threatening complication during pregnancy (~5–7%), and no causative treatment is available. Early aberrant spiral artery remodeling is associated with placental stress and the release of oxygen radicals and other reactive oxygen species (ROS) in the placenta. This precedes the production of anti-angiogenic factors, which ultimately leads to endothelial and trophoblast damage and the key features of PE. We tested whether a novel dual-function redox modulator—AKT-1005—can effectively reduce placental oxidative stress and alleviate PE symptoms in vitro. Method: Isolated human villous explants were exposed to hypoxia and assessed to determine whether improving cell-redox function with AKT-1005 diminished ROS production, mitochondrial stress, production of the transcription factor HIF1A, and downstream anti-angiogenic responses (i.e., sFLT1, sEng production). MitoTEMPO was used as a reference antioxidant. Results: In our villous explant assays, pretreatment with AKT-1005 reduced mitochondrial-derived ROS production, reduced HIF-1A, sFLT1, and sEng protein expression, while increasing VEGF in hypoxia-exposed villous trophoblast cells, with better efficiency than MitoTEMPO. In addition, AKT-1005 improved mitochondrial electron chain enzyme activity in the stressed explant culture. Conclusions: The redox modulator AKT-1005 has the potential to intervene with oxidative stress and can be efficacious for PE therapy. Future studies are underway to assess the in vivo efficacy of HMP. Full article
(This article belongs to the Special Issue Maternal Adaptation in Physiological and Pathological Pregnancy)
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15 pages, 2063 KiB  
Article
Prediction Model for Pre-Eclampsia Using Gestational-Age-Specific Serum Creatinine Distribution
by Jieun Kang, Sangwon Hwang, Taesic Lee, Kwangjin Ahn, Dong Min Seo, Seong Jin Choi and Young Uh
Biology 2023, 12(6), 816; https://doi.org/10.3390/biology12060816 - 04 Jun 2023
Viewed by 1272
Abstract
Pre-eclampsia (PE) is a pregnancy-related disease, causing significant threats to both mothers and babies. Numerous studies have identified the association between PE and renal dysfunction. However, in clinical practice, kidney problems in pregnant women are often overlooked due to physiologic adaptations during pregnancy, [...] Read more.
Pre-eclampsia (PE) is a pregnancy-related disease, causing significant threats to both mothers and babies. Numerous studies have identified the association between PE and renal dysfunction. However, in clinical practice, kidney problems in pregnant women are often overlooked due to physiologic adaptations during pregnancy, including renal hyperfiltration. Recent studies have reported serum creatinine (SCr) level distribution based on gestational age (GA) and demonstrated that deviations from the expected patterns can predict adverse pregnancy outcomes, including PE. This study aimed to establish a PE prediction model using expert knowledge and by considering renal physiologic adaptation during pregnancy. This retrospective study included pregnant women who delivered at the Wonju Severance Christian Hospital. Input variables, such as age, gestational weeks, chronic diseases, and SCr levels, were used to establish the PE prediction model. By integrating SCr, GA, GA-specific SCr distribution, and quartile groups of GA-specific SCr (GAQ) were made. To provide generalized performance, a random sampling method was used. As a result, GAQ improved the predictive performance for any cases of PE and triple cases, including PE, preterm birth, and fetal growth restriction. We propose a prediction model for PE consolidating readily available clinical blood test information and pregnancy-related renal physiologic adaptations. Full article
(This article belongs to the Special Issue Maternal Adaptation in Physiological and Pathological Pregnancy)
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21 pages, 4162 KiB  
Article
Term and Preterm Birth Initiation Is Associated with the Macrophages Shifting to M1 Polarization in Gestational Tissues in Mice
by Yali Shan, Shiping Shen, Jing Long, Zhengshan Tang, Cichun Wu and Xin Ni
Biology 2022, 11(12), 1759; https://doi.org/10.3390/biology11121759 - 04 Dec 2022
Cited by 4 | Viewed by 1470
Abstract
Inflammation in gestational tissues plays critical role in parturition initiation. We sought to investigate the leukocyte infiltration and cytokine profile in uterine tissues to understand the inflammation during term and preterm labor in the mouse model. Preterm birth was induced by the administration [...] Read more.
Inflammation in gestational tissues plays critical role in parturition initiation. We sought to investigate the leukocyte infiltration and cytokine profile in uterine tissues to understand the inflammation during term and preterm labor in the mouse model. Preterm birth was induced by the administration of lipopolysaccharide (LPS) or RU38486. The populations of leukocytes were determined by flow cytometry. Macrophages were the largest population in the myometrium and decidua in late gestation. The macrophage population was significantly changed in the myometrium and decidua from late pregnancy to term labor and significantly changed at LPS- and RU386-induced preterm labor. Neutrophils, T cells, and NKT cells were increased in LPS- and RU38486-induced preterm labor. The above changes were accompanied by the increased expression of cytokines and chemokines. In late gestation, M2 macrophages were the predominant phenotype in gestational tissues. M1 macrophages significantly increased in these tissues at term and preterm labor. IL-6 and NLRP3 expression was significantly increased in macrophages at labor, supporting that macrophages exhibit proinflammatory phenotypes. NLRP3 inflammasome inhibitor MCC950 mainly suppressed macrophage infiltration in the myometrium at term labor and preterm labor. Our data suggest that the M1 polarization of macrophages contributes to inflammation linked to term and preterm labor initiation in gestational tissues. Full article
(This article belongs to the Special Issue Maternal Adaptation in Physiological and Pathological Pregnancy)
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Review

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27 pages, 2288 KiB  
Review
Glucocorticoids and Their Receptor Isoforms: Roles in Female Reproduction, Pregnancy, and Foetal Development
by Sreeparna Bhaumik, Jack Lockett, James Cuffe and Vicki L. Clifton
Biology 2023, 12(8), 1104; https://doi.org/10.3390/biology12081104 - 09 Aug 2023
Viewed by 1905
Abstract
Alterations in the hypothalamic–pituitary–adrenal (HPA) axis and associated changes in circulating levels of glucocorticoids are integral to an organism’s response to stressful stimuli. Glucocorticoids acting via glucocorticoid receptors (GRs) play a role in fertility, reproduction, placental function, and foetal development. GRs are ubiquitously [...] Read more.
Alterations in the hypothalamic–pituitary–adrenal (HPA) axis and associated changes in circulating levels of glucocorticoids are integral to an organism’s response to stressful stimuli. Glucocorticoids acting via glucocorticoid receptors (GRs) play a role in fertility, reproduction, placental function, and foetal development. GRs are ubiquitously expressed throughout the female reproductive system and regulate normal reproductive function. Stress-induced glucocorticoids have been shown to inhibit reproduction and affect female gonadal function by suppressing the hypothalamic–pituitary–gonadal (HPG) axis at each level. Furthermore, during pregnancy, a mother’s exposure to prenatal stress or external glucocorticoids can result in long-lasting alterations to the foetal HPA and neuroendocrine function. Several GR isoforms generated via alternative splicing or translation initiation from the GR gene have been identified in the mammalian ovary and uterus. The GR isoforms identified include the splice variants, GRα and GRβ, and GRγ and GR-P. Glucocorticoids can exert both stimulatory and inhibitory effects and both pro- and anti-inflammatory functions in the ovary, in vitro. In the placenta, thirteen GR isoforms have been identified in humans, guinea pigs, sheep, rats, and mice, indicating they are conserved across species and may be important in mediating a differential response to stress. Distinctive responses to glucocorticoids, differential birth outcomes in pregnancy complications, and sex-based variations in the response to stress could all potentially be dependent on a particular GR expression pattern. This comprehensive review provides an overview of the structure and function of the GR in relation to female fertility and reproduction and discusses the changes in the GR and glucocorticoid signalling during pregnancy. To generate this overview, an extensive non-systematic literature search was conducted across multiple databases, including PubMed, Web of Science, and Google Scholar, with a focus on original research articles, meta-analyses, and previous review papers addressing the subject. This review integrates the current understanding of GR variants and their roles in glucocorticoid signalling, reproduction, placental function, and foetal growth. Full article
(This article belongs to the Special Issue Maternal Adaptation in Physiological and Pathological Pregnancy)
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