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When a baby is born small, it’s often attributed to genetic factors or maternal risk factors like poor nutrition or smoking. But a twin study led by researchers at Boston Children’s Hospital now find that slower transport of oxygen from mother to baby across the placenta predicts slower fetal growth, as well as a smaller brain and liver.

The study, published in Scientific Reports is the first to make a direct connection between birth outcomes and placental oxygen transport.

By studying identical twins, the researchers were uniquely able to control for both genetic factors and maternal risk factors. Although identical twins also share a placenta, it is divided into two separate compartments, and one may be healthier than the other.

P. Ellen Grant, MD, director of Boston Children’s Fetal-Neonatal Neuroimaging and Developmental Science Center, and Elfar Adalsteinsson, PhD at MIT have developed a noninvasive method that uses MRI to map the timing of oxygen delivery across the placenta in real time. Using this technique, called Blood-Oxygenation-Level-Dependent (BOLD) MRI, they showed that dysfunctional placentas have large regions with slow oxygen transport to the fetus.

“Until now, we had no way to look at regional placental function in vivo,” says Grant. “Prenatal ultrasound or routine clinical MRI can assess placental structure, but cannot assess regional function, which is not uniform across the placenta. Doppler ultrasound, the current clinical method of assessing placental function, measures blood flow in the umbilical arteries and other fetal vessels, but it cannot tell how well oxygen or nutrients are being transported from mother to fetus.”

Real-time placental oxygen mapping

In the new study, part of the NIH-funded Human Placenta Project, Grant, co-senior investigator Julian Robinson, MD, chief of obstetrics at Brigham and Women’s Hospital (BWH), and their colleagues followed seven sets of identical twins all the way to birth, specifically tracking pregnancies in which one twin was smaller than the other.

At 29 to 34 weeks of pregnancy, the seven mothers underwent BOLD MRI for about 30 minutes. While they inhaled pure oxygen for 10-minute stretches, Grant’s team measured how long it took oxygen to reach its maximum concentration in the placenta, known as…

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Mayra Rodriguez

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Mayra Rodriguez
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