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Article

Fetal Oxygenation from the 23rd to the 36th Week of Gestation Evaluated through the Umbilical Cord Blood Gas Analysis

by
Luca Filippi
1,2,*,
Francesca Pascarella
2,
Alessandro Pini
3,
Maurizio Cammalleri
4,
Paola Bagnoli
4,
Riccardo Morganti
5,
Francesca Innocenti
2,
Nicola Castagnini
2,
Alice Melosi
2 and
Rosa Teresa Scaramuzzo
2
1
Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
2
Neonatology Unit, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy
3
Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
4
Unit of General Physiology, Department of Biology, University of Pisa, 56126 Pisa, Italy
5
Section of Statistics, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2023, 24(15), 12487; https://doi.org/10.3390/ijms241512487
Submission received: 4 July 2023 / Revised: 2 August 2023 / Accepted: 4 August 2023 / Published: 6 August 2023
(This article belongs to the Special Issue Physiology and Pathophysiology of Placenta)
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Abstract

The embryo and fetus grow in a hypoxic environment. Intrauterine oxygen levels fluctuate throughout the pregnancy, allowing the oxygen to modulate apparently contradictory functions, such as the expansion of stemness but also differentiation. We have recently demonstrated that in the last weeks of pregnancy, oxygenation progressively increases, but the trend of oxygen levels during the previous weeks remains to be clarified. In the present retrospective study, umbilical venous and arterial oxygen levels, fetal oxygen extraction, oxygen content, CO2, and lactate were evaluated in a cohort of healthy newborns with gestational age < 37 weeks. A progressive decrease in pO2 levels associated with a concomitant increase in pCO2 and reduction in pH has been observed starting from the 23rd week until approximately the 33–34th week of gestation. Over this period, despite the increased hypoxemia, oxygen content remains stable thanks to increasing hemoglobin concentration, which allows the fetus to become more hypoxemic but not more hypoxic. Starting from the 33–34th week, fetal oxygenation increases and ideally continues following the trend recently described in term fetuses. The present study confirms that oxygenation during intrauterine life continues to vary even after placenta development, showing a clear biphasic trend. Fetuses, in fact, from mid-gestation to near-term, become progressively more hypoxemic. However, starting from the 33–34th week, oxygenation progressively increases until birth. In this regard, our data suggest that the placenta is the hub that ensures this variable oxygen availability to the fetus, and we speculate that this biphasic trend is functional for the promotion, in specific tissues and at specific times, of stemness and intrauterine differentiation.
Keywords: newborn; intrauterine hypoxia; fetal hypoxia; differentiation newborn; intrauterine hypoxia; fetal hypoxia; differentiation

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MDPI and ACS Style

Filippi, L.; Pascarella, F.; Pini, A.; Cammalleri, M.; Bagnoli, P.; Morganti, R.; Innocenti, F.; Castagnini, N.; Melosi, A.; Scaramuzzo, R.T. Fetal Oxygenation from the 23rd to the 36th Week of Gestation Evaluated through the Umbilical Cord Blood Gas Analysis. Int. J. Mol. Sci. 2023, 24, 12487. https://doi.org/10.3390/ijms241512487

AMA Style

Filippi L, Pascarella F, Pini A, Cammalleri M, Bagnoli P, Morganti R, Innocenti F, Castagnini N, Melosi A, Scaramuzzo RT. Fetal Oxygenation from the 23rd to the 36th Week of Gestation Evaluated through the Umbilical Cord Blood Gas Analysis. International Journal of Molecular Sciences. 2023; 24(15):12487. https://doi.org/10.3390/ijms241512487

Chicago/Turabian Style

Filippi, Luca, Francesca Pascarella, Alessandro Pini, Maurizio Cammalleri, Paola Bagnoli, Riccardo Morganti, Francesca Innocenti, Nicola Castagnini, Alice Melosi, and Rosa Teresa Scaramuzzo. 2023. "Fetal Oxygenation from the 23rd to the 36th Week of Gestation Evaluated through the Umbilical Cord Blood Gas Analysis" International Journal of Molecular Sciences 24, no. 15: 12487. https://doi.org/10.3390/ijms241512487

APA Style

Filippi, L., Pascarella, F., Pini, A., Cammalleri, M., Bagnoli, P., Morganti, R., Innocenti, F., Castagnini, N., Melosi, A., & Scaramuzzo, R. T. (2023). Fetal Oxygenation from the 23rd to the 36th Week of Gestation Evaluated through the Umbilical Cord Blood Gas Analysis. International Journal of Molecular Sciences, 24(15), 12487. https://doi.org/10.3390/ijms241512487

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