The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes
Healthy fetal development is dependent on nutrient and oxygen transfer via the placenta. Optimal growth and function of placental vasculature is therefore essential to support in utero development. Vasculogenesis, the de novo formation of blood vessels, and angiogenesis, the branching and remodeling...
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doaj-c940692571344761abacd0c1113c6e0b2020-11-25T00:37:48ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2019-08-011010.3389/fmicb.2019.01924476006The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth OutcomesAndrea M. Weckman0Michelle Ngai1Julie Wright2Chloe R. McDonald3Kevin C. Kain4Kevin C. Kain5Kevin C. Kain6Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, CanadaSAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, CanadaDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, CanadaSAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, CanadaDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, CanadaSAR Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, ON, CanadaTropical Disease Unit, Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, ON, CanadaHealthy fetal development is dependent on nutrient and oxygen transfer via the placenta. Optimal growth and function of placental vasculature is therefore essential to support in utero development. Vasculogenesis, the de novo formation of blood vessels, and angiogenesis, the branching and remodeling of existing vasculature, mediate the development and maturation of placental villi, which form the materno-fetal interface. Several lines of evidence indicate that systemic maternal infection and consequent inflammation can disrupt placental vasculogenesis and angiogenesis. The resulting alterations in placental hemodynamics impact fetal growth and contribute to poor birth outcomes including preterm delivery, small-for-gestational age (SGA), stillbirth, and low birth weight (LBW). Furthermore, pathways involved in maternal immune activation and placental vascularization parallel those involved in normal fetal development, notably neurovascular development. Therefore, immune-mediated disruption of angiogenic pathways at the materno-fetal interface may also have long-term neurological consequences for offspring. Here, we review current literature evaluating the influence of maternal infection and immune activation at the materno-fetal interface and the subsequent impact on placental vascular function and birth outcome. Immunomodulatory pathways, including chemokines and cytokines released in response to maternal infection, interact closely with the principal pathways regulating placental vascular development, including the angiopoietin-Tie-2, vascular endothelial growth factor (VEGF), and placental growth factor (PlGF) pathways. A detailed mechanistic understanding of how maternal infections impact placental and fetal development is critical to the design of effective interventions to promote placental growth and function and thereby reduce adverse birth outcomes.https://www.frontiersin.org/article/10.3389/fmicb.2019.01924/fullinfectionpregnancyplacentavascular developmentadverse birth outcomes |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andrea M. Weckman Michelle Ngai Julie Wright Chloe R. McDonald Kevin C. Kain Kevin C. Kain Kevin C. Kain |
spellingShingle |
Andrea M. Weckman Michelle Ngai Julie Wright Chloe R. McDonald Kevin C. Kain Kevin C. Kain Kevin C. Kain The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes Frontiers in Microbiology infection pregnancy placenta vascular development adverse birth outcomes |
author_facet |
Andrea M. Weckman Michelle Ngai Julie Wright Chloe R. McDonald Kevin C. Kain Kevin C. Kain Kevin C. Kain |
author_sort |
Andrea M. Weckman |
title |
The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes |
title_short |
The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes |
title_full |
The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes |
title_fullStr |
The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes |
title_full_unstemmed |
The Impact of Infection in Pregnancy on Placental Vascular Development and Adverse Birth Outcomes |
title_sort |
impact of infection in pregnancy on placental vascular development and adverse birth outcomes |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Microbiology |
issn |
1664-302X |
publishDate |
2019-08-01 |
description |
Healthy fetal development is dependent on nutrient and oxygen transfer via the placenta. Optimal growth and function of placental vasculature is therefore essential to support in utero development. Vasculogenesis, the de novo formation of blood vessels, and angiogenesis, the branching and remodeling of existing vasculature, mediate the development and maturation of placental villi, which form the materno-fetal interface. Several lines of evidence indicate that systemic maternal infection and consequent inflammation can disrupt placental vasculogenesis and angiogenesis. The resulting alterations in placental hemodynamics impact fetal growth and contribute to poor birth outcomes including preterm delivery, small-for-gestational age (SGA), stillbirth, and low birth weight (LBW). Furthermore, pathways involved in maternal immune activation and placental vascularization parallel those involved in normal fetal development, notably neurovascular development. Therefore, immune-mediated disruption of angiogenic pathways at the materno-fetal interface may also have long-term neurological consequences for offspring. Here, we review current literature evaluating the influence of maternal infection and immune activation at the materno-fetal interface and the subsequent impact on placental vascular function and birth outcome. Immunomodulatory pathways, including chemokines and cytokines released in response to maternal infection, interact closely with the principal pathways regulating placental vascular development, including the angiopoietin-Tie-2, vascular endothelial growth factor (VEGF), and placental growth factor (PlGF) pathways. A detailed mechanistic understanding of how maternal infections impact placental and fetal development is critical to the design of effective interventions to promote placental growth and function and thereby reduce adverse birth outcomes. |
topic |
infection pregnancy placenta vascular development adverse birth outcomes |
url |
https://www.frontiersin.org/article/10.3389/fmicb.2019.01924/full |
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