Also known as the afterbirth, the placenta is a unique organ that adapts to intrauterine environmental stressors such as maternal undernutrition to ensure optimal foetal growth. Nevertheless, we lack mechanistic understanding of the tipping point when the placental adaptation becomes pathophysiological [a condition typically observed during a disease state] leading to foetal growth restriction and low birth weight. This has immediate and delayed consequences since the foetal origins hypothesis proposes that the risk of developing non-communicable diseases in adulthood has a foundation in suboptimal foetal growth and small size at birth.
Considering that two-fifth of the low-birth weight babies in developing countries are born in India, it becomes crucial to understand the molecular pathways that mediate foetal adaptation to suboptimal intrauterine conditions in the Indian population comprising of multiple ancestries, cultures and associated food and lifestyle factors.
To be able to capture the range of variability of placental and birth correlates in a heterogenous population, the need of the hour is at-scale and systematic examination of the placentae. We have developed methods and are using them to collect and preserve placentae. Utilising the 400 placentae collected from our birth cohort, we are beginning to address questions related to the transcriptional and epigenetic control of genes in critical regulatory pathways in the placenta to understand the cause of foetal growth restriction.
Recent findings from our group’s work published in the journal Placenta indicate that the placental transcript abundance of an imprinted gene, growth receptor binding protein 10 (GRB10), is associated with human foetoplacental [pertaining to the foetus and placenta] growth in a gender-specific manner.
The long-term vision of our group is to systematically engage with the mechanistic basis of adaptation to nutritional and environmental exposures in the seemingly intractable problem of low-birth weight in India, with the eventual goal of informing sensible preventive strategies.
Mukhopadhyay is assistant professor, division of nutrition, St John's Research Institute, St John's National Academy of Health Sciences in Bengaluru.