Abstract

Key points Fetal growth restriction (FGR) is a major risk factor for stillbirth and has significant impact upon lifelong health.A small, poorly functioning placenta, as evidenced by reduced transport of nutrients to the baby, underpins FGR. It remains unclear how a small but normal placenta differs from the small FGR placenta in terms of ability to transfer nutrients to the fetus.Placental transport of glutamine and glutamate, key amino acids for fetal growth, was assessed in normal mice and those with FGR.Glutamine and glutamate transport was greater in the lightest versus heaviest placenta in a litter of normally grown mice. Placentas of mice with FGR had increased transport capacity in mid‐pregnancy, but this adaptation was insufficient in late pregnancy.Placental adaptations, in terms of increased nutrient transport (per gram) to compensate for small size, appear to achieve appropriate fetal growth in normal pregnancy. Failure of this adaptation might contribute to FGR. Fetal growth restriction (FGR), a major risk factor for stillbirth, and neonatal and adulthood morbidity, is associated with reduced placental size and decreased placental nutrient transport. In mice, a small, normal placenta increases its nutrient transport, thus compensating for its reduced size and maintaining normal fetal growth. Whether this adaptation occurs for glutamine and glutamate, two key amino acids for placental metabolism and fetal growth, is unknown. Additionally, an assessment of placental transport of glutamine and glutamate between FGR and normal pregnancy is currently lacking. We thus tested the hypothesis that the transport of glutamine and glutamate would be increased (per gram of tissue) in a small normal placenta [C57BL6/J (wild‐type, WT) mice], but that this adaptation fails in the small dysfunctional placenta in FGR [insulin‐like growth factor 2 knockout (P0) mouse model of FGR]. In WT mice, comparing the lightest versus heaviest placenta in a litter, unidirectional maternofetal clearance (K mf) of 14C‐glutamine and 14C‐glutamate (glutamine K mf and glutamate K mf) was significantly higher at embryonic day (E) 18.5, in line with increased expression of LAT1, a glutamine transporter protein. In P0 mice, glutamine K mf and glutamate K mf were higher (P0 versus wild‐type littermates, WTL) at E15.5. At E18.5, glutamine K mf remained elevated whereas glutamate K mf was similar between groups. In summary, we provide evidence that glutamine K mf and glutamate K mf adapt according to placental size in WT mice. The placenta of the growth‐restricted P0 fetus also elevates transport capacity to compensate for size at E15.5, but this adaptation is insufficient at E18.5; this may contribute to decreased fetal growth.

Highlights

  • Placental dysfunction is a major cause of pregnancy complications such as fetal growth restriction (FGR) (Mifsud & Sebire, 2014), which is characterised by poor growth in utero and has immediate and life-long consequences (Veen et al 1991; Barker, 2004; Thornton et al 2004; Gardosi et al 2013)

  • Fetuses from the lightest placentas were significantly lighter at E15.5 and E18.5, yet the magnitude of this difference was smaller towards term (13%, P < 0.001 at E15.5; 5%, Placental weight lightest/heaviest (%)

  • Perturbations in placental transport of these amino acids may contribute to reduced fetal growth (FGR)

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Summary

Introduction

Placental dysfunction is a major cause of pregnancy complications such as fetal growth restriction (FGR) (Mifsud & Sebire, 2014), which is characterised by poor growth in utero and has immediate and life-long consequences (Veen et al 1991; Barker, 2004; Thornton et al 2004; Gardosi et al 2013). One facet of this placental dysfunction is abnormal nutrient transport by the syncytiotrophoblast, the transporting epithelium of the placenta. Glutamate is a neurotransmitter (Olsen & Sonnewald, 2015) and fetal plasma levels must be carefully controlled during fetal brain development because high levels of glutamate are neurotoxic (Tian et al 2012)

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