Sex-specific placental adaptations associated with fetal growth restriction: a review

Area of Science:

• Obstetrics and Gynecology
• Developmental Biology
• Reproductive Science

Background:

• Fetal growth restriction (FGR) is a major complication of placental insufficiency, leading to adverse perinatal and long-term health outcomes.
• The placenta's role in fetal development and maternal-fetal communication is critical; its dysfunction impairs fetal growth.
• Historically, research has overlooked fetal sex differences in placental development and adaptation to intrauterine stress.

Purpose of the Study:

• To review and synthesize current evidence on sex-specific placental adaptations to various intrauterine stressors.
• To highlight the importance of considering fetal sex in understanding FGR and its consequences.
• To inform the development of targeted interventions for improved fetal and neonatal outcomes.

Main Methods:

• Systematic review of human studies and experimental animal models of FGR.
• Analysis of data on placental development, function, and adaptive responses.
• Synthesis of findings related to nutrient restriction, hypoxia, and maternal hyperthermia.

Main Results:

• Male and female placentas exhibit distinct adaptive strategies under stress.
• Female placentas show greater adaptability, while male placentas prioritize growth, potentially reducing resilience.
• Observed sex differences in placental adaptation correlate with neonatal outcomes and adult disease risk.

Conclusions:

• Fetal sex is a critical determinant of placental adaptation to intrauterine conditions.
• Recognizing sex-specific placental responses is essential for advancing FGR research and clinical interventions.
• Understanding these adaptations can enhance livestock productivity and neonatal survival in agriculture.