Lowland origin women raised at high altitude are not protected against lower uteroplacental O2 delivery during pregnancy or reduced birth weight

Am J Hum Biol. 2011 Jul-Aug;23(4):509-16. doi: 10.1002/ajhb.21167. Epub 2011 Apr 27.

Abstract

Objective: Maternal physiologic responses to pregnancy promoting fetal oxygen and nutrient delivery are important determinants of reproductive success. Incomplete physiologic compensation for reduced oxygen availability at high altitude (≥2,500 m) compromises fetal growth. Populations of highland (e.g., Andeans, Tibetans) compared with lowland origin groups (e.g., Europeans, Han Chinese) are protected from this altitude-associated decrease in birth weight; here we sought to determine whether maternal development at high altitude-rather than highland ancestry-contributed to the protection of birth weight and uterine artery (UA) blood flow during pregnancy.

Methods: In women of lowland ancestry who were either raised at high altitude in La Paz, Bolivia (3,600-4,100 m) ("lifelong," n = 18) or who had migrated there as adults ("newcomers," n = 40) we compared maternal O(2) transport during pregnancy and their infant's birth weight.

Results: Pregnancy raised maternal ventilation and arterial O(2) saturation equally, with the result that arterial O(2) content was similarly maintained at nonpregnant levels despite a fall in hemoglobin. UA blood flow and uteroplacental O(2) delivery were lower in lifelong than newcomer residents (main effect). Birth weight was similar in lifelong residents versus newcomers (2,948 ± 93 vs. 3,090 ± 70 gm), with both having values below those of a subset of eight high-altitude residents who descended to deliver at low altitude (3,418 ± 133 gm, P < 0.05).

Conclusion: Lifelong compared with newcomer high-altitude residents have lower uteroplacental O(2) delivery and similar infant birth weights, suggesting that developmental factors are likely not responsible for the protective effect of highland ancestry.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adaptation, Physiological*
  • Adult
  • Age Factors
  • Altitude Sickness
  • Altitude*
  • Apgar Score
  • Bolivia
  • Child
  • Confidence Intervals
  • Delivery, Obstetric
  • Female
  • Geography
  • Hemodynamics
  • Hemoglobins
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Mental Health
  • Oxygen / blood*
  • Oxygen / metabolism
  • Oxygen Consumption
  • Pregnancy
  • Pregnancy Outcome*
  • Surveys and Questionnaires
  • Time Factors
  • Uterine Artery*
  • Women's Health*

Substances

  • Hemoglobins
  • Oxygen