If you’ve been pregnant, did you ever think about your placenta? Did you even have an image of it in your mind’s eye?
Your uterus, sure, especially as it grew and grew. Your fetus, of course, aided by grainy ultrasound print-outs. But your placenta, that essential life-support system, that unique biological bridge that is neither truly you nor your child — probably not so much, unless you faced a rare and risky complication. (Or you’re a member of the very small club that believes in eating bits of the afterbirth — please don’t make me go there.)
Personally, through a miscarriage and two pregnancies, I never gave my placenta a single thought. But new research suggests that by ignoring the placenta, we may miss out — not just on a personal level but a societal one.
“The placenta is basically the last frontier in human organs,” says radiologist Dr. P. Ellen Grant of Boston Children’s Hospital. “It’s the least understood, yet arguably one of the most important organs. For years it’s been neglected, and we’re only beginning to understand the complex role of the placenta in fetal development from conception to delivery, and in long-term outcomes not only for the fetus but also for the mother.”
Dr. Grant’s team has just won a nearly $5 million grant to develop better methods to image and monitor the placenta during pregnancy.
“The placenta is actually the Rodney Dangerfield of organs.”
It will focus in particular on pregnant women who are obese, a growing population that faces higher risks of complications, including pre-term birth, stillbirth and pre-eclampsia.
The grant is part of the Human Placenta Project, a major new federal effort that is funding a total of $46 million in research. The project aims to counter that longstanding neglect and increase understanding of the placenta’s role in disease.
“The placenta is actually the Rodney Dangerfield of organs,” says Dr. Diana Bianchi, executive director of the Mother Infant Research Institute at Tufts Medical Center, who was involved in the federal strategizing that led to the Human Placenta Project. (Note to young folks: Dangerfield was a comedian famed for his complaint, “I don’t get no respect.”)
“The placenta, until now, really hasn’t gotten respect by funding authorities and it hasn’t gotten a lot of attention,” Bianchi continued. As parents-to-be focus on the fetus, she said, most “don’t realize that the placenta is essentially the foundation for the normal development of the baby, because it supplies nutrients, it supplies oxygen, it takes the waste products away from the baby, and it also is an amazing machine for the production of hormones. So it’s doing an amazing amount of work during the entire pregnancy, and yet at the very end of it, it’s thrown out.”
Given all that critical work, surely if the placenta falls down on the job in any way, complications of pregnancy may result.
Pre-eclampsia, a potentially life-threatening complication of pregnancy that affects up to 8 percent of mothers-to-be, is directly related to the placenta, Dr. Bianchi said. It involves “an abnormal development of the placenta, in that the placenta doesn’t really invade the mother’s uterus correctly, and the consequence of that is abnormal blood flow between the baby and its mother.”
Obesity is so widespread in America that among some sub-populations of women, more than half are obese, Dr. Grant said. Continue reading