Pregnancy at high altitude in the Andes leads to increased total vessel density in healthy newborns
Norina N. Gassmann (Erasmus MC, Universitat Zurich)
Hugo A. Van Elteren (Erasmus MC)
Tom G. Goos (Erasmus MC, TU Delft - Mechanical Engineering)
Claudia R. Morales (Universidad Peruana Cayetano Heredia)
Maria Rivera-Ch (Universidad Peruana Cayetano Heredia)
Daniel S. Martin (University College London)
Patricia Cabala Peralta (Universidad Peruana Cayetano Heredia)
Agustin Passano Del Carpio
Saul Aranibar MacHaca
Luis Huicho (Universidad Peruana Cayetano Heredia)
Irwin K.M. Reiss (Erasmus MC)
Max Gassmann (Universitat Zurich, Universidad Peruana Cayetano Heredia)
Rogier C.J. De Jonge (Erasmus MC)
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Abstract
The developing human fetus is able to cope with the physiological reduction in oxygen supply occurring in utero. However, it is not known if microvascularization of the fetus is augmented when pregnancy occurs at high altitude. Fifty-three healthy term newborns in Puno, Peru (3,840 m) were compared with sea-level controls. Pre-and postductal arterial oxygen saturation (SpO2) was determined. Cerebral and calf muscle regional tissue oxygenation was measured using near infrared spectroscopy (NIRS). Skin microcirculation was noninvasively measured using incident dark field imaging. Pre-and postductal SpO2 in Peruvian babies was 88.1 and 88.4%, respectively, which was 10.4 and 9.7% lower than in newborns at sea level (P=0.001). Cerebral and regional oxygen saturation was significantly lower in the Peruvian newborns (cerebral: 71.0 vs. 74.9%; regional: 68.5 vs. 76.0%, P=0.001). Transcutaneously measured total vessel density in the Peruvian newborns was 14% higher than that in the newborns born at sea level (29.7 vs. 26.0 mm/mm2; P=0.001). This study demonstrates that microvascular vessel density in neonates born to mothers living at high altitude is higher than that in neonates born at sea level.