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“Foetal–Maternal Conflicts” and Adverse Outcomes in Human Pregnancies

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Evolutionary Thinking in Medicine

Abstract

During normal pregnancy, there is a fine equilibrium between foetal and maternal interests. Some pregnancy complications appear to arise from a conflict of interest between the foetuses, which is trying to maximize the supply of nutrients from the mother, and the latter who is trying to preserve her reproductive future. This chapter reviews accumulating evidence to support the hypothesis that abnormal foetal–maternal interactions may be the basis of some pregnancy complications associated with abnormal foetal growth, foetal death and maternal complication including pre-eclampsia, gestational diabetes and thrombophilia.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, TX, USA

    Jimmy Espinoza M.D., M.Sc., FACOG

  2. Texas Children’s Hospital Pavilion for Women, Houston, TX, USA

    Jimmy Espinoza M.D., M.Sc., FACOG

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  1. Jimmy Espinoza M.D., M.Sc., FACOG
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Correspondence to Jimmy Espinoza M.D., M.Sc., FACOG .

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Editors and Affiliations

  1. Oxford, United Kingdom

    Alexandra Alvergne

  2. Oxford, United Kingdom

    Crispin Jenkinson

  3. Paris, France

    Charlotte Faurie

Glossary

Pre-eclampsia

Hypertensive disorder of pregnancy that typically starts after the 20th week of pregnancy.

Genomic imprinting

The process by which one copy of a gene is silenced due to its parental origin.

Mole pregnancy

Results from a genetic error during the fertilization process that leads to growth of abnormal placenta within the uterus.

Grb10

Growth factor receptor-bound protein 10 also known as insulin receptor-binding protein.

Spiral arteries

Small arteries that are remodelled into highly dilated vessels during pregnancy to increase the blood supply to foetal and placental tissues.

Placental bed disorders

Refers to defective placentation in the human which is associated with pregnancy complications such pre-eclampsia, foetal growth restriction, and foetal death.

Uteroplacental ischaemia

During pregnancy, the uterus and placenta form a functional unit. This term refers to reduced blood flow to this unit.

Angiogenic factors

Promote the viability and growth of endothelial cells. Foetal signalling: proposed pathways used by the foetus to alter the maternal of placental physiology.

HELLP syndrome

A severe form of pre-eclampsia characterized by abnormal liver enzymes, low platelets and destruction of red blood cells.

Adenosine

Compound that plays an important role in energy transfer signal transduction and regulation of blood flow to various organs.

Uterine artery Doppler velocimetry

Ultrasonographic technique to evaluate the characteristics of blood flow in vessels.

VEGF

Vascular endothelial growth factor is a signalling protein involved in the formation and growth of blood vessels.

sFlt-1

Splice variant of VEGF receptor 1an excess of this soluble form in the circulation can reduce the bioavailability of VEGF (anti-angiogenic).

Thrombophilia

Abnormality of blood coagulation that increases the risk of thrombosis.

Tocolysis

Medical interventions to reduce or stop uterine contractions.

Allocrine hormones

Foreign hormones being taken up and eliciting a response in an organism.

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Espinoza, J. (2016). “Foetal–Maternal Conflicts” and Adverse Outcomes in Human Pregnancies. In: Alvergne, A., Jenkinson, C., Faurie, C. (eds) Evolutionary Thinking in Medicine. Advances in the Evolutionary Analysis of Human Behaviour. Springer, Cham. https://doi.org/10.1007/978-3-319-29716-3_2

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  • DOI: https://doi.org/10.1007/978-3-319-29716-3_2

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