Current views on the pathogenesis of fetal growth restriction

The review article analyzes the data available in the modern literature on the actual aspects of the development of fetal growth restriction (FGR). The review includes data from foreign and Russian articles published in Pubmed and eLibrary. Currently, there is no common understanding of the pathogenesis of FGR. Of particular interest are the ways of forming different phenotypes of FGR. The development of FGR and the latter concurrent with preeclampsia (PE) is rooted in impaired trophoblast invasion; the differences are mainly in the degree of impairment. The literature review considers the aspects of the occurrence of FGR, which are associated with the pathology of the second wave of cytotrophoblast invasion, with an impaired vascular wall remodeling process during placental development, as well as the epigenetic mechanisms of FGR development and the features of the transcriptome. A number of epigenetic mechanisms, including DNA methylation processes, various modifications of histones and noncoding RNAs, have been identified in recent years. The scientific literature has published the results of numerous studies of placental microRNAs as potential biomarkers for the diagnosis of early-onset FGR and/or PE, since they can play a role in the pattern of pathophysiological processes in the context of the epigenetic regulators that affect gene expression in placental tissues and are also able to circulate in the maternal bloodstream and to be determined in maternal plasma. Conclusion. The determination of placental microRNAs in maternal blood showed an increase in the concentration of differentially expressed microRNAs in women with severe early-onset FGR and a correlation with the umbilical artery blood flow velocity rate. The modern aspects of the development of FGR are summarized, by analyzing the data available in the literature.

fetal growth restriction, preeclampsia, a wave of trophoblast invasion, microRNA, transcriptome