Is fetal growth restriction caused by failure of the placenta to adapt to nutrient demand?

Dr Christina Hayward, Kirsty McIntyre, Dr Susan Greenwood, Dr Paul Brownbill, Dr Richard Unwin, Professor Colin Sibley, Dr Mark Dilworth

In this study we will compare placentas from normal and Fetal Growth Restricted-affected pregnancies to identify what the important signals might be.

Babies that don’t grow as expected are at greater risk of being stillborn. Should these babies survive, they are then at a greater risk of disability in childhood, such as cerebral palsy or developmental delay. There are now well-defined links between being born small, termed fetal growth restriction (FGR), and an increased risk of diseases. Thus, FGR is responsible for a significant emotional and financial burden on families and the NHS, both before and after birth. 

For the growth of the baby to proceed as normal, a placenta that functions as normal is crucial. If the placenta fails to function, fetal growth restriction (FGR) may occur. 

Evidence suggests that in normal pregnancies, the baby is able to signal to the mother to alter the amount of nutrients getting across, via the placenta. In FGR, there is evidence that this signalling between baby and mother fails. This means that the transfer of nutrients by the placenta is insufficient for normal growth and FGR occurs.This study aims to examine the signals that baby produces in more detail. In the study we will compare placentas from normal and FGR-affected pregnancies to identify what these important signals might be. This includes using cutting-edge technologies to identify key markers within umbilical cord blood (which flows from the baby to the placenta) and the baby’s side of the placenta (where these signals would act). We can then test these signals in placentas after delivery of the baby to determine whether they alter placental transfer of nutrients in a way that would be beneficial for the baby. 

This study will shed new light onto how baby is able to signal back to mother and how these signals cause changes in the delivery of nutrients back to baby by the placenta. We hope that this information will allow us to improve growth outcomes in at-risk pregnancies.

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