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Am J Physiol Regul Integr Comp Physiol 296: R1564-R1575, 2009. First published February 25, 2009; doi:10.1152/ajpregu.90945.2008
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DEVELOPMENTAL PHYSIOLOGY AND PREGNANCY

Augmented uterine artery blood flow and oxygen delivery protect Andeans from altitude-associated reductions in fetal growth

¹Altitude Research Center, Department of Surgery, Division of Emergency Medicine, University of Colorado Denver, Colorado; ²Department of Health and Behavioral Sciences, University of Colorado Denver, Colorado; ³Graduate School of Arts and Sciences, Wake Forest University, Winston-Salem, North Carolina; ⁴Instituto Boliviano de Biología de Altura, Universidad Mayor de San Andrés, La Paz, Bolivia; ⁵Clinica Siraní, Santa Cruz de la Sierra, Bolivia; ⁶Pennsylvania State University, Anthropological Genomics Laboratory, State College, Pennsylvania; and ⁷Clínica del Sur, La Paz, Bolivia

Submitted 20 November 2008 ; accepted in final form 20 February 2009

The effect of high altitude on reducing birth weight is markedly less in populations of high- (e.g., Andeans) relative to low-altitude origin (e.g., Europeans). Uterine artery (UA) blood flow is greater during pregnancy in Andeans than Europeans at high altitude; however, it is not clear whether such blood flow differences play a causal role in ancestry-associated variations in fetal growth. We tested the hypothesis that greater UA blood flow contributes to the protection of fetal growth afforded by Andean ancestry by comparing UA blood flow and fetal growth throughout pregnancy in 137 Andean or European residents of low (400 m; European n = 28, Andean n = 23) or high (3,100–4,100 m; European n = 51, Andean n = 35) altitude in Bolivia. Blood flow and fetal biometry were assessed by Doppler ultrasound, and maternal ancestry was confirmed, using a panel of 100 ancestry-informative genetic markers (AIMs). At low altitude, there were no ancestry-related differences in the pregnancy-associated rise in UA blood flow, fetal biometry, or birth weight. At high altitude, Andean infants weighed 253 g more than European infants after controlling for gestational age and other known influences. UA blood flow and O₂ delivery were twofold greater at 20 wk in Andean than European women at high altitude, and were paralleled by greater fetal size. Moreover, variation in the proportion of Indigenous American ancestry among individual women was positively associated with UA diameter, blood flow, O₂ delivery, and fetal head circumference. We concluded that greater UA blood flow protects against hypoxia-associated reductions in fetal growth, consistent with the hypothesis that genetic factors enabled Andeans to achieve a greater pregnancy-associated rise in UA blood flow and O₂ delivery than European women at high altitude.

genetic adaptation; hypoxia; intrauterine growth restriction; uteroplacental blood flow

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				G. F. Gonzales, K. Steenland, and V. Tapia Maternal hemoglobin level and fetal outcome at low and high altitudes Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2009; 297(5): R1477 - R1485. [Abstract] [Full Text] [PDF]