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Interconversion of cortisol and cortisone in the baboon placenta at midgestation: expression of 11beta-hydroxysteroid dehydrogenase type 1 messenger RNA.

At midgestation in the baboon, 11beta-hydroxysteroid dehydrogenase (11beta-HSD) catalysed interconversion of cortisol (F) and cortisone (E) during transuterine passage favors the formation of F. Because the site(s) of oxidation/reduction of F and E are not clear, the present study compared F-E interconversion in placenta, decidua and chorion in vitro. In addition, because the reduction of E to F is catalysed only by the 11beta-HSD-1, we also determined whether the mRNA for this enzyme was expressed in baboon placenta, including placental syncytiotrophoblast cells; the site of fetal-maternal exchange. Placentas were obtained on day 100 of gestation (term = day 184) and villous tissue, decidua and chorion isolated, minced in HBSS and incubated (300-400 mg) in duplicate for 0.1-24 h in Medium 199 containing 10% fetal bovine serum and [3H]F and [14C]E. Radiolabelled F and E were purified from incubates and the percentage conversion of F to E and E to F was calculated. In decidua, mean (+/- SE; n = 3) conversion of E to F (69 +/- 2%) was greater than oxidation of F to E (26 +/- 2%). Conversion of E to F in placenta (50 +/- 1%) and chorion (39 +/- 9%) was also extensive and greater than or equal to that for the oxidation of F to E (39 +/- 4% and 32 +/- 4%, respectively). The apparent ratio of 11beta-HSD reductive/oxidative activity was maintained when respective tissues from four baboons were incubated for 18 h with or without 4.4 microM excess radioinert substrate. Expression of 11beta-HSD-1 mRNA was determined by Northern blot by hybridization of poly (A) + -enriched RNA from tissues obtained at midgestation with [32P]labelled human 11beta-HSD-1 cDNA. This cDNA hybridized to a single mRNA species of 1.6 kb in decidua, whole placental villous tissue and syncytiotrophoblast cells, but not to RNA isolated from fetal baboon kidney. The results of the present study demonstrate that at midgestation in the baboon, 11beta-HSD activity in intact placenta and decidua in vitro favored the formation of F from E, presumably catalysed by the 11beta-HSD-1 enzyme protein, the mRNA for which is present in placental syncytiotrophoblasts. Moreover, based on overall mass and extensive vascularity, we suggest that the net formation of F from E during transuterine passage in vivo at this stage of gestation results from the 11beta-HSD-1 in the syncytiotrophoblast cells of the baboon placenta.

11-beta-Hydroxysteroid Dehydrogenases↗

Risk factors of abruptio placentae among Peruvian women.

OBJECTIVE: We examined the relation of maternal sociodemographic, medical, and behavioral characteristics with risk of abruptio placentae in Peruvian women. STUDY DESIGN: This case-control study included 255 abruptio placentae cases and 258 pregnant controls. Multivariable logistic regression models were fit to calculate odds ratios (OR) and 95% CIs adjusted for putative abruptio placentae risk factors. RESULTS: History of delivering a stillborn infant (OR 10.0; 95%CI 4.0-25.2), pregnancy complicated by preeclampsia/eclampsia (OR 3.7; 95%CI 2.2-6.3); and a low rate of pregnancy weight gain (<0.15 kg/wk) (OR 2.5; 95%CI 1.3-4.7), were associated with significantly increased risk of abruptio placentae. Advanced maternal age, low educational attainment, male infant gender, cigarette smoking, and grand multiparty were not risk factors of abruptio placentae in this population. CONCLUSION: At present, the constellation of abruptio placentae risk factors do not provide clinically meaningful opportunities for identifying high-risk patients.

Abruptio Placentae↗

Analyses of the potential oxygen transfer capability in placentae from infants succumbing to sudden infant death syndrome.

BACKGROUND: Morphometric oxygen diffusive conductance (Dp) was estimated to assess the potential efficiency of oxygen transfer across the materno-fetal interface in placentae obtained from victims of sudden infant death syndrome (SIDS). STUDY DESIGN: SIDS placentae were retrieved from archived storage and classified into normal birth weight (NBW, n=16), or small for gestational age (SGA, n=9) and compared against control placentae (n=40) or SGA (n=24) placentae. A combination of stereological techniques and physiological constants were used to estimate total Dp. RESULTS: SIDS NBW cases showed a crucial reduction in fetal capillary surface area when compared with control placentae. SIDS SGA showed a number of deficiencies in basic volumetric and surface area parameters. Values for total and specific Dp in placentae in both SIDS groups were maintained at levels comparable with control and SGA cases, respectively. CONCLUSION: Since more reductions were observed in SIDS SGA group, this suggests that factors responsible for these reductions maybe associated with SGA rather than being SIDS-specific factors.

Adult↗

Difference in the expression of alpha 7 nicotinic receptors in the placenta in normal versus severe preeclampsia pregnancies.

OBJECTIVE: The prevalence of preeclampsia is low in smokers, suggesting a possible role of nicotinic receptor in the pathophysiology of the disease. Alpha 7 nicotinic acetylcholine receptor (alpha7 nAChR) was recently found in non-neuronal tissue with various mediating functions. Therefore, we investigated the difference in the placental expression of the alpha7 nAChR in normal versus severe preeclampsia placentas. STUDY DESIGN: Central portions of placenta were obtained from 9 severe preeclampsia women and 11 gestational-age-matched normal pregnant women delivered between the gestational ages of 33 and 40 weeks following elective or emergency cesarean section. RT-PCR, western blotting, and immunohistochemical staining were performed to evaluate the alpha7 nAChR expression difference. RESULTS: In all the placentas, the alpha7 nAChR was expressed in endothelial cells, vascular smooth muscle cells, and stromal cells, but not in trophoblasts. The vascular staining was more intense in the severe preeclampsia placenta (p=0.02). Although the gene expression did not differ between the two groups, protein expression was greater in 7 of 9 placenta samples from the severe preeclampsia group. CONCLUSION: Placental expression of alpha7 nAChR differs between normal and severe preeclampsia placentas, suggesting that it may be involved in the pathogenesis of preeclampsia.

Adult↗

Interleukin-6 and insulin-like growth factor system relationships and differences in the human placenta and fetus from the 35th week of gestation.

The integrity of the insulin-like growth factor (IGF) system is essential for normal fetal growth. Cytokine and IGF-IGFBP relationships have been shown in specific tissues, but it is unknown whether these occur in the placenta. We aimed to assess possible differences in the IGF system depending on gestational age (GA) from week 35 to 40, and to study relationships of IL-6 with components of the IGF system in the placenta and newborn infant. We followed 32 normal births and collected whole villous tissue and cord serum. Total RNA was extracted from the placenta samples, reverse transcribed and then real-time quantitative (TaqMan) RT-PCR was performed to quantify cDNA for IGF-I, IGF-II, IGFBP-1, IGFBP-2 and IL-6. The corresponding proteins were assayed in placenta lysates and cord serum using specific commercial kits. Two groups of subjects (Group 1, 35-37 weeks GA, N=12 and Group 2, 38-40 weeks GA, N=20) were studied. In placenta, IGF-I mRNA was more abundant than IGF-II mRNA at all times and together with IGFBP-1mRNA were less expressed at term. IGFBP-2 and IL-6 mRNAs were higher after week 37 GA. IL-6 and IGFBP-2 gene expression were closely related. The corresponding proteins showed similar differences to the genes but IGF-I was undetectable in the lysates, whereas IGF-II was abundant. IGFBP-2 concentrations were very high and greater than those of IGFBP-1. In the newborn, no difference was seen in any cord serum protein after week 35 GA. IGFBP-1 was negatively correlated with parameters of neonatal size. In conclusion, this study reports new insights into IL-6, IGF-IGFBP relationships within the human placenta and shows the importance of comparing subjects with the same GA.

Adult↗

Sublingual nitroglycerin for management of retained placenta.

OBJECTIVE: The aim of the study was to investigate the effect of sublingual nitroglycerin for management of retained placenta and to assess possible adverse effects of the treatment. METHOD: Twenty-four women were randomly selected to receive either 1 mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin and controlled umbilical cord traction had failed to expel the placenta. Success rate for delivery of placenta, blood pressure, pulse rate, blood loss, and various side effects were examined. RESULT: All 12 women in the nitroglycerin group had successful delivery of placenta, while removal of placenta was successful in only one of the 12 women in the placebo group. No adverse effects of clinical importance were registered. CONCLUSION: Sublingual nitroglycerin for treatment of retained placenta seems to be effective without causing serious adverse effects. However, the definite clinical value needs to be evaluated in larger series of patients.

Administration, Sublingual↗

Different effects of magnesium sulfate and angiotensin II on the capacity of the fetal and maternal compartments of normal human placenta to secrete TNF-alpha and IL-6.

Three different protocols were carried out to evaluate the effect of magnesium sulfate (MgSO4) on the capacity of the normal human placenta to secrete TNF-alpha and IL-6 in presence and absence of angiotensin II (AII). Ten placentas were perfused with MgSO4 (6-7 mg%) or medium in the absence or presence of AII. Perfusate samples from fetal and maternal sites were collected and examined for IL-6 and TNF-alpha by ELISA. The maternal site of placentas exposed to AII showed only basal levels of TNF-alpha. Exposure of the placentas to MgSO4 resulted in significant increase in TNF-alpha and IL-6 in the maternal site (p < 0.05). However, the effect of MgSO4 was significantly attenuated by AII injected in presence of MgSO4. TNF-alpha and IL-6 levels in the maternal site significantly decreased (p < 0.05). The fetal site of the placentas exposed to MgSO4 or AII separately showed only basal levels of TNF-alpha and IL-6. However, TNF-alpha and IL-6 levels were significantly higher after injection of AII in the presence of MgSO4 compared to TNF-alpha levels in the fetal site of placentas exposed to AII alone (p < 0.05) or MgSO4 alone (p < 0.01). MgSO4 induced the ability of the placental maternal site to secrete TNF-alpha and IL-6. In the presence of both MgSO4 and AII, the effect of MgSO4 on the maternal site was significantly reduced. However, in the fetal site, MgSO4 alone had no significant effect on TNF-alpha and IL-6 levels although, in presence of AII and MgSO4, there was a significant increase in TNF-alpha and IL-6 levels. Elevation of TNF-alpha and IL-6 in the fetal compartment, which may affect fetal brain growth and development and placental function should be considered before administration of MgSO4 during pregnancy.

Angiotensin II↗

Complex regulation of Calbindin-D(9k) in the mouse placenta and extra-embryonic membrane during mid- and late pregnancy.

Calbindin-D(9k) (CaBP-9k) is a cytosolic calcium-binding protein mainly expressed in the duodenum, uterus and placenta, however, the role of CaBP-9k in the regulation of fetal growth remains to be elucidated. The present study was performed to investigate the expression pattern and regulation of CaBP-9k by antagonists of steroid hormones related with steroid hormone receptors during mid- and late pregnancy in mouse placenta and extra-embryonic membrane. The expression level of CaBP-9k increased in the placenta, while it decreased in the extra-embryonic membrane during pregnancy. The mRNA expression levels of estrogen receptor alpha (ERalpha) and progesterone receptor (PR) appeared to increase in both placenta and extra-embryonic membrane during pregnancy, suggesting that the ER and PR mRNA and protein expressions of placental CaBP-9k are positively correlated, but expressions of extra-embryonic membrane CaBP-9k are reversely correlated with ERalpha and PR mRNA levels. In addition, the present study indicates that the expressions of CaBP-9k mRNA and protein are differentially up- or down-regulated by antagonists of estrogen (E2) and progesterone (P4) in mouse placenta and extra-embryonic membranes, which suggests that E2 and P4 may be dominant factors in the regulation of the CaBP-9k. In particular, RU486, an antagonist of P4, down-regulated the mRNA and protein levels of placental CaBP-9k, whereas it up-regulated the protein level of extra-embryonic membrane CaBP-9k. In conclusion, we demonstrated that the CaBP-9k is distinctly regulated in the mouse placenta and extra-embryonic membrane, probably via sex steroid hormones (E2 and P4) and their receptors through a complex pathway. Extended studies are needed to verify relevant factors to regulate CaBP-9k gene and to provide further insight into roles of CaBP-9k gene in these tissues for the control of reproductive functions.

Animals↗

Comparative study of gene expression of cholinergic system-related molecules in the human spinal cord and term placenta.

By reverse transcription-polymerase chain reaction, Southern blot analysis, direct sequencing, and immunohistochemistry, we studied the expression of cholinergic neuronal markers (choline acetyltransferase [ChAT], vesicular acetylcholine transporter [VAChT], and a high-affinity choline transporter [CHT1]), and gene regulatory molecules (repressor element-1 silencing transcription factor/neuron-restrictive silencer factor [REST/NRSF] and CoREST) in the human spinal cord and term placenta, both of which are well known to contain cells synthesizing acetylcholine. H-type, M-type, N2-type, and R-type ChAT mRNAs, VAChT mRNA, and CHT1 mRNA were detected in the spinal cord, but only H-type, M-type, and N2-type ChAT mRNAs, in the term placenta. REST/NRSF and CoREST were detected in the spinal cord and the placenta, but the amounts of both mRNAs were greater in the placenta than in the spinal cord. Further microdissection analyses revealed that the placental trophoblastic cells contained more REST/NRSF and CoREST transcripts than the spinal large motor neurons. Large motor neurons in the anterior horn of the spinal cord were immunohistochemically stained for ChAT and VAChT. In the placenta, stromal fibroblasts, endothelial cells, and trophoblastic cells of the chorionic villi were positively stained with anti-ChAT antibody but not with anti-VAChT antibody. These findings suggest that transcriptions of the R-type ChAT and VAChT mRNAs are coordinately suppressed in the human term placenta, which might be regulated in part by a REST/NRSF complex that binds to a consensus sequence of repressor element 1/neuron-restrictive silencer element (RE1/NRSE) in the 5' region upstream from exon R, whereas transcriptions of the H-type, M-type, and N2-type ChAT mRNAs might be independent of control by RE1/NRSE. It is possible that at least two separate regulatory mechanisms of gene expression are present for the human cholinergic gene locus, which might be selected by different combinations of DNA motifs and binding proteins to function in neuronal and non-neuronal cells.

Acetylcholine↗

Glucose metabolism in the human preterm and term placenta of IUGR fetuses.

Many fetuses suffering from intrauterine growth restriction (IUGR) are hypoglycaemic. However, the underlying mechanisms are not well established. An increased placental glucose consumption in IUGR could impair glucose transfer across the placenta. In this study we used two different approaches to investigate glucose metabolism in preterm and term placentae of IUGR fetuses. We determined activity and protein expression of the three rate-limiting glycolytic enzymes phosphofructo kinase (PFK), pyruvate kinase (PK) and hexokinase (HXK) in a cytoplasmic fraction of homogenates of placentae obtained from IUGR and appropriate for gestational age (AGA) pregnancies. Protein expression was assessed using Western blot and enzyme activities were determined in a spectrophotometer by measuring the rate of NADH oxidation (PFK and PK) or NADP reduction (HXK) in enzyme reactions coupled to the respective enzyme. To determine the distribution of the glycolytic enzymes immunocytochemistry was performed. We also measured glucose consumption and lactate production in fresh placental villous tissue using a perifusion system. The expression of PFK, PK and HXK as well as the activity of PK and HXK was unaltered in IUGR placentae. The activity of PFK on the other hand was 32 per cent lower in IUGR placentae (n=24, P<0.05). Immunocytochemistry confirmed the distribution of the enzymes to the cytoplasm of the syncytiotrophoblast. Placental glucose consumption in IUGR [0.06+/-0.01 micromol/(min*g), n=5] was not different from AGA [0.06+/-0.005 micromol/(min*g), n=12], whereas lactate production was decreased by 28 per cent in IUGR. These results do not support the hypothesis of increased placental glucose consumption but suggest an altered glycolytic pathway in the IUGR placenta.

Adult↗

Ontogeny of StAR and ACTH-R genes in ovine placenta.

It has been demonstrated that the ovine placenta secretes estrogen, progesterone and cortisol, and that plasma concentrations of estrogen and cortisol increase before birth. Among the elements important for steroid production is steroidogenic acute regulatory protein (StAR) which acutely delivers cholesterol from the outer to the inner mitochondrial membrane for rapid steroidogenesis. This study was designed to determine if StAR is present in ovine placenta, and if its expression changes during fetal development. In addition, because cortisol is secreted by the placenta, we also examined the expression of adrenocorticotropic hormone receptor (ACTH-R) to determine if it was present and if the pattern of expression changed as gestation proceeded. The mRNA levels for StAR and ACTH-R were assessed by RNase protection assay (RPA) and protein levels were measured by Western blot in placentas from pregnant ewes (100-105 days of gestation, n = 8; 120 days of gestation, n = 5; 135-142 days of gestation, n = 8). The data show that the ovine placenta expresses StAR and ACTH-R. There was a significant increase in the StAR mRNA and protein between 100 and 142 days of gestation, but there were no significant age-related changes in ACTH-R mRNA and protein levels. The data suggest that the increased steroid production by the placenta in late gestation may be related to the increased expression of StAR.

Animals↗

Leptin expression in the fetus and placenta during mouse pregnancy.

During pregnancy, leptin concentrations in the maternal circulation are elevated in both humans and rodents but decrease to pre-pregnancy levels at birth, suggesting a role for leptin in the maintenance of pregnancy. Synthesis of leptin by the human placenta is established but whether the murine placenta synthesizes leptin remains controversial. The aims of this study were to determine (a) if the mouse wild-type placenta expresses the ob gene using Reverse Transcription-Polymerase Chain Reaction (RT-PCR) and (b) whether the mouse fetus and placenta contribute to the significant increase of leptin in the maternal circulation during pregnancy. The mouse placenta did not express the ob gene at a level that could be readily detected using RT-PCR. Moreover, both maternal gain in weight and undetectable concentrations of leptin in sera in leptin-deficient ob/ob mothers bearing heterozygote (ob/+) fetuses suggested that the mouse fetus and placenta do not make a significant contribution to the dramatic increase in maternal plasma concentrations of leptin during late gestation. It is therefore concluded that neither fetal- nor placental-derived leptin modulates maternal weight gain during pregnancy.

Amniotic Fluid↗

Less HLA-G expression in Plasmodium falciparum-infected third trimester placentas is associated with more natural killer cells.

During pregnancy, maternal immune tolerance of the fetal semi-allogeneic graft is partly the consequence of extravillous trophoblast HLA-G expression and its interaction with natural killer (NK) cells. Plasmodium falciparum malaria is frequently associated with maternal and fetal complications. Local HLA-G expression and the number of NK cells were evaluated immunohistochemically in P. falciparum-infected and uninfected placentas (15 each) collected in a seasonal malaria-hypoendemic area. In control placentas, HLA-G was almost always expressed in extravillous trophoblast whereas, in infected placentas, it was significantly more weakly expressed in extravillous trophoblast but was also detected in intervillous space macrophages. NK cells were evaluated in intervillous and intravillous spaces and in basal plate. NK cells were always more abundant in basal plate than in intervillous and intravillous spaces in infected or control placentas. For each area, more NK cells were seen in infected than control placentas. These data suggest that HLA-G down-regulation and more NK cells in placentas may be among the mechanisms involved in poor birth outcome associated with P. falciparum infection.

Adolescent↗

Human placenta: a human organ for developmental toxicology research and biomonitoring.

Pregnant mothers are exposed to a wide variety of foreign chemicals. This exposure is most commonly due to maternal medication, lifestyle factors, such as smoking, drug abuse, and alcohol consumption, or occupational and environmental sources. Foreign compounds may interfere with placental functions at many levels e.g. signaling, production and release of hormones and enzymes, transport of nutrients and waste products, implantation, cellular growth and maturation, and finally, at the terminal phase of placental life, i.e. delivery. Placental responses may also be due to pharmaco-/toxicodynamic responses to foreign chemicals, e.g. hypoxia. On the other hand, placental xenobiotic-metabolizing enzymes can detoxify or activate foreign chemicals, and transporters either enhance or prevent cellular accumulation and transfer across the placenta. The understanding of what xenobiotics do to the placenta and what the placenta does to the xenobiotics should provide the basis for the use of placenta as a tool to investigate and predict some aspects of developmental toxicity. This review aims to give an update of the fate and behavior of xenobiotics in the placenta from the viewpoint of xenobiotic-metabolizing enzymes and transporters. Their response levels will be described according to gestational status and methods used. The effects of foreign chemicals on placental metabolizing enzymes will be discussed. Also, interactions in the transporter protein level will be covered. The role of the placenta in contributing to developmental effects and fetotoxicity will be examined. The toxicological effects of maternal medications, smoking, and environmental exposures (dioxins, pesticides) as well as some possibilities for biomonitoring will be highlighted.

Animals↗

Contractile cells and fibrillin-1 distribution is disturbed in terminal villi of placentae from patients with preeclampsia and systemic lupus erythematosus.

Placentae from patients with preeclampsia (PE) and systemic lupus erythematosus (SLE) present many alterations that may impair materno-fetal exchange. We investigated the distribution of contractile cells and fibrillin-1 in terminal villi of term placentae from patients with PE or SLE and compared to control placentae. Stroma in terminal villi exhibited intense labelling for fibrillin-1. The fibrillin-1 villi surface fraction was greater in PE and SLE placentae than in controls (13+/-0.4%, 14+/-0.5%, 10+/-0.4%; p=0.0001). Immunohistochemistry for alpha-smooth muscle (SM) actin showed few contractile cells in control terminal villi stroma, localized around fetal capillaries and showed rare processes in vasculo-syncytial membrane. PE and SLE placentae exhibited an increase in the number of capillaries presenting alpha-SM actin adventitial positive cells. The presence of alpha-SM actin processes interposed in the vasculo-syncytial membrane was greater in SLE villi than in PE and controls. Ultrastructural observations confirmed in SLE and PE terminal villi the presence of these processes in vasculo-syncytial membrane and also showed a thickened trophoblastic basement membrane. The present study demonstrates that an important myofibroelastic system is present in term terminal villi, and that this system is actively remodelled in PE and SLE placentae.

Actins↗

High glucose alters proteoglycan expression and the glycosaminoglycan composition in placentas of women with gestational diabetes mellitus and in cultured trophoblasts.

Impaired glucose metabolism with diabetes may alter the expressions of proteoglycans (PGs), which may impair the biological functions of placenta. In this study, we investigated the expression of PGs and their conjugated glycosaminoglycan (GAG) composition in the placentas of mothers with gestational diabetes mellitus (GDM) and trophoblasts cultured in a high-glucose condition. The PGs by guanidine/HCl extraction and DEAE Sepharose fractionation followed by GAG degradation enzyme digestion analyses showed that the expression of chondroitin sulfate and/or dermatan sulfate (CS/DS) PGs was increased whereas the heparan sulfate (HS) PG was decreased in GDM placentas compared to controls. Western blot analyses demonstrated that the increased CS/DS PGs in GDM placentas were predominantly the small leucine-rich proteoglycans (SLRPs), decorin and biglycan. Increased mRNA expression level was consistently shown by quantitative real-time PCR. Immunohistochemistry indicated intensive staining of decorin and biglycan in the diabetic placenta with different localizations. Additionally, the basement membrane HSPG, perlecan was found to contain both CS/DS and HS in GDM placentas and plain HS in controls. Similar findings of PG alterations induced by hyperglycemia were observed in cultured trophoblast in a high-glucose condition. This study demonstrated that hyperglycemia induced not only the gene expressions of PGs but also alterations in the carried GAG type and composition.

Cells, Cultured↗

Organochlorine pesticides in placentas from Southern Spain and some related factors.

During pregnancy, lipophilic xenobiotics stored in maternal adipose tissue can be mobilized and enter her blood circulation and reach the placenta. This study measured residues of oestrogen-mimicking organochlorine pesticides (OCs) in 150 placenta samples from women in Southern Spain. OCs were extracted from placenta by solid-liquid technique and purified by preparative liquid chromatography. Gas chromatography/electron-capture detection and mass spectrometry were used to identify and quantify p,p'-DDT and congeners/metabolites, endosulphan and congeners/metabolites, lindane, aldrin/dieldrin/endrin, hexachlorobenzene, methoxychlor and mirex. A mean of eight pesticides per placenta were detected (range, 3-15 pesticides). Endosulphan-ether, endosulphan-diol, endosulphan-I, p,p'-DDE, o,p'-DDD, p,p'-DDT, o,p'-DDT and lindane were detected in >or=50% of samples; p,p'-DDE was the most frequent (96.03%), followed by endosulphan-diol (76.86%) and lindane (74.17%). Presence of more pesticides was significantly associated with lower birth weight. Mean concentration of p,p'-DDE was 2.37+/-2.80 ng/g of placenta or 76.62+/-104.85 ng/g of lipid. Higher maternal body mass index was significantly associated with higher endosulphan concentrations in placenta, and greater maternal weight gain was significantly associated with higher p,p'-DDE concentrations. Prenatal exposure to OC xenoestrogens may be a causative factor in adverse reproductive health trends, and further studies are required to identify and describe pathways of this exposure to enhance preventive measures.

Adult↗

Growth and function of the normal human placenta.

The placenta is the highly specialised organ of pregnancy that supports the normal growth and development of the fetus. Growth and function of the placenta are precisely regulated and coordinated to ensure the exchange of nutrients and waste products between the maternal and fetal circulatory systems operates at maximal efficiency. The main functional units of the placenta are the chorionic villi within which fetal blood is separated by only three or four cell layers (placental membrane) from maternal blood in the surrounding intervillous space. After implantation, trophoblast cells proliferate and differentiate along two pathways described as villous and extravillous. Non-migratory, villous cytotrophoblast cells fuse to form the multinucleated syncytiotrophoblast, which forms the outer epithelial layer of the chorionic villi. It is at the terminal branches of the chorionic villi that the majority of fetal/maternal exchange occurs. Extravillous trophoblast cells migrate into the decidua and remodel uterine arteries. This facilitates blood flow to the placenta via dilated, compliant vessels, unresponsive to maternal vasomotor control. The placenta acts to provide oxygen and nutrients to the fetus, whilst removing carbon dioxide and other waste products. It metabolises a number of substances and can release metabolic products into maternal and/or fetal circulations. The placenta can help to protect the fetus against certain xenobiotic molecules, infections and maternal diseases. In addition, it releases hormones into both the maternal and fetal circulations to affect pregnancy, metabolism, fetal growth, parturition and other functions. Many placental functional changes occur that accommodate the increasing metabolic demands of the developing fetus throughout gestation.

Carbohydrates↗