Insight into the pathogenesis of fetal growth restriction in placental malaria: Decreased placental glucose transporter isoform 1 expression

Placental malaria, especially when complicated with intervillositis, can cause fetal growth restriction. Transplacental glucose transport by glucose transporter isoform 1 (GLUT-1) on the syncytiotrophoblast microvillous and basal plasma membranes regulates fetal growth. We found that GLUT-1 expression in the microvillous plasma membrane of Plasmodium falciparum-negative placenta biopsy specimens was comparable to that in P. falciparum-positive placenta biopsy specimens with or without intervillositis, whereas GLUT-1 expression in the basal plasma membrane was lowest in P. falciparum-positive placenta biopsy specimens with intervillositis, compared with the other 2 specimen types (P ≤. 0016). GLUT-1 expression in the basal plasma membrane also correlated negatively with monocyte infiltrate density (r =-0.43; P =. 003) and positively with birth weight (r = 0.28; P =. 06). These findings suggest that intervillositis, more than placental malaria per se, might cause fetal growth restriction, through impaired transplacental glucose transport. © 2013 The Author.