Abstract

Current tests available to diagnose fetal hypoxia in-utero lack sensitivity thus failing to identify many fetuses at risk. Emerging evidence suggests that microRNAs derived from the placenta circulate in the maternal blood during pregnancy and may be used as non-invasive biomarkers for pregnancy complications. With the intent to identify putative markers of fetal growth restriction (FGR) and new therapeutic druggable targets, we examined, in maternal blood samples, the expression of a group of microRNAs, known to be regulated by hypoxia. The expression of microRNAs was evaluated in maternal plasma samples collected from (1) women carrying a preterm FGR fetus (FGR group) or (2) women with an appropriately grown fetus matched at the same gestational age (Control group). To discriminate between early- and late-onset FGR, the study population was divided into two subgroups according to the gestational age at delivery. Four microRNAs were identified as possible candidates for the diagnosis of FGR: miR-16-5p, miR-103-3p, miR-107-3p, and miR-27b-3p. All four selected miRNAs, measured by RT-PCR, resulted upregulated in FGR blood samples before the 32nd week of gestation. By contrast, miRNA103-3p and miRNA107-3p, analyzed between the 32nd and 37th week of gestation, showed lower expression in the FGR group compared to aged matched controls. Our results showed that measurement of miRNAs in maternal blood may form the basis for a future diagnostic test to determine the degree of fetal hypoxia in FGR, thus allowing the start of appropriate therapeutic interventions to alleviate the burden of this disease.

Highlights

  • Hypoxia may occur acutely during labor and birth, or develop gradually across pregnancy in cases of fetal growth restriction (FGR) due to placental dysfunction [1, 2]

  • Most of Healthy fetuses were delivered spontaneously near term of pregnancy, while maternal blood samples were made matched with FGR ones at the same gestational weeks

  • In the present pilot study, we identified for the first time a panel of hypoxia-induced miRNAs differently expressed in the maternal blood of pregnant women with FGR fetuses compared to matched age pregnancies of healthy fetuses

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Summary

Introduction

Hypoxia may occur acutely during labor and birth, or develop gradually across pregnancy in cases of fetal growth restriction (FGR) due to placental dysfunction [1, 2]. The early-onset FGR, occurring at

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