国际妇产科学杂志 ›› 2026, Vol. 53 ›› Issue (1): 93-97.doi: 10.12280/gjfckx.20251117

• 产科生理及产科疾病: 综述 • 上一篇    下一篇

胎儿生长受限中胎盘病因学的研究进展

王洪博, 张龑()   

  1. 100191 北京大学第三医院妇产科
  • 收稿日期:2025-09-29 出版日期:2026-02-15 发布日期:2026-03-11
  • 通讯作者: 张龑 E-mail:zhangyann01@126.com

Research Progress on the Placental Etiology of Fetal Growth Restriction

WANG Hong-bo, ZHANG Yan()   

  1. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191,China
  • Received:2025-09-29 Published:2026-02-15 Online:2026-03-11
  • Contact: ZHANG Yan E-mail:zhangyann01@126.com

摘要:

胎儿生长受限(fetal growth restriction,FGR)是围产儿患病及死亡的重要诱因,其发病机制复杂,涉及胎儿、母体及胎盘等多层面因素。作为母胎间物质交换及内分泌调控的核心器官,胎盘的结构与功能异常在FGR发病中起着关键作用。近年研究揭示,FGR的发生不仅伴随胎盘体积缩小、绒毛树结构紊乱等宏观形态学改变,并深入关联到滋养细胞增殖、分化功能障碍,导致螺旋动脉重塑不足。表观遗传学进展揭示FGR的发生伴随胎盘基因组印记异常、DNA甲基化模式改变及多种微RNA表达失调。上述改变可通过调控胎盘发育、血管生成与细胞应激反应参与FGR的形成。随着多组学发展,FGR胎盘病因学研究正在向更精细的细胞与分子层面深化。系统综述胎盘形态学、细胞功能学及表观遗传学在FGR中的研究进展,以期加深对其病理机制的理解,为早期识别及精准干预提供科学依据。

关键词: 胎儿生长迟缓, 胎盘, 滋养层, 子宫动脉, 基因组印记, 表观基因组学, 微RNAs

Abstract:

Fetal growth restriction (FGR) is an important contributor of perinatal morbidity and mortality. Its pathogenesis is complex, involving multiple factors at the fetal, maternal, and placental levels. As a core organ for material exchange and endocrine regulation between the mother and the fetus, abnormal placental structure and function play a crucial role in the pathogenesis of FGR. In recent years, studies have revealed that the occurrence of FGR is not only accompanied by macroscopic morphological changes such as reduced placental volume and disrupted villous tree structure but is also deeply associated with dysfunctions in trophoblast proliferation and differentiation, leading to insufficient remodeling of the spiral arteries. Advances in epigenetics have shown that the occurrence of FGR is accompanied by abnormal genomic imprinting in the placenta, alterations in DNA methylation patterns, and dysregulated expression of various microRNAs. These changes can contribute to the development of FGR by regulating placental development, angiogenesis, and cellular stress responses. With the development of multi-omics, research on the placental etiology of FGR is deepening to more refined cellular and molecular levels. This review summarizes the research progress of placental morphology, cell functional studies, and epigenetics in FGR, aiming to enhance the understanding of its pathological mechanisms and provide a scientific basis for early identification and precise intervention.

Key words: Fetal growth retardation, Placenta, Trophoblasts, Uterine artery, Genomic imprinting, Epigenomics, MicroRNAs