Lewis, R. M.; Demmelmair, Hans; Gaillard, R.; Godfrey, K. M.; Hauguel-de Mouzon, S.; Huppertz, B.; Larque, E.; Saffery, R.; Symonds, M. E.; Desoye, G.
The Placental Exposome: Placental Determinants of Fetal Adiposity and Postnatal Body Composition.
In: Annals of Nutrition and Metabolism, No. 3: pp. 208-215
Offspring of obese and diabetic mothers are at increased risk of beingborn with excess adiposity as a consequence of their intrauterineenvironment. Excessive fetal fat accretion reflects additional placentalnutrient transfer, suggesting an effect of the maternal environment onplacental function. High plasma levels of particular nutrients in obeseand diabetic mothers are likely to be the important drivers of nutrienttransfer to the fetus, resulting in excess fat accretion. However, notall offspring of obese and diabetic mothers are born large forgestational age and the explanation may involve the regulation ofplacental nutrient transfer required for fetal growth. The placentaintegrates maternal and fetal signals across gestation in order todetermine nutrient transfer rate. Understanding the nature of thesesignals and placental responses to them is key to understanding thepathology of both fetal growth restriction and macrosomia. The overalleffects of the maternal environment on the placenta are the product ofits exposures throughout gestation, the ‘placental exposome’.Understanding these environmental influences is important as exposuresearly in gestation, for instance causing changes in the function ofgenes involved in nutrient transfer, may determine how the placenta willrespond to exposures later in gestation, such as to raised maternalplasma glucose or lipid concentrations. Longitudinal studies arerequired which allow investigation of the influences on the placentaacross gestation. These studies need to make full use of developingtechnologies characterising placental function, fetal growth and bodycomposition. Understanding these processes will assist in thedevelopment of preventive strategies and treatments to optimise prenatalgrowth in those pregnancies at risk of either excess or insufficientnutrient supply and could also reduce the risk of chronic disease inlater life.