Chances are you know what the placenta is. The crucial organ providing nutrients and survival for a growing baby. However, new research is revealing there is MUCH more to this crucial organ’s role. Did you know it appears important from the very earliest stages even influencing implantation/conception!? All the way to having long term implications for a child’s health. We are going to take a look at some of the things you need to know about the placenta. Then, most importantly seven evidence-based ways you can give yours a helping hand. 

The latest research is showing the impact of the placenta may be much more long lasting when it comes to health of a baby and may even influence implantation… 

So most of us probably think of the placenta only in the context of pregnancy. However, one of the most prestigious medical journals: Nature, recently reported findings from Cambridge University suggesting that the placenta may even play a role in implantation. ie. it is important even as early as conception.

In fact, when scientists looked at the very earliest period (post fertilisation) they saw that the first cells to differentiate were actually the placental progenitor cells (the cell from which the placenta forms).

Why does this matter? 

Well, if this mechanism is not appropriately established, then there can be significant consequences for the development of the embryo and its ability to successfully implant in the womb…

This could be crucial for conception and fertility treatments: 

We already know that during IVF, one of the most significant predictors of an embryo implanting in the womb is the appearance of placental progenitor cells under the microscope. There is still a lot more work to be done on this but nevertheless the findings are important.

But it doesn’t stop there: the placenta appears to be far more important than we had realised… 

This organ is not only crucial for supplying all the important things for a baby’s growth, but we also know it can play a role in the long term health of a developing baby (11). It is actually phenomenally clever – check out some of the functions it performs (1):

• passing oxygen and nutrients to the baby
• Secreting and regulating hormones and the mother’s adaption to pregnancy hormones/changes.
• Conversion of cortisol (stress hormone) from the mother to its inactive form (Cortisone) reducing the impact on the baby.
• Acting as a selective barrier: allowing some things in and blocking out others
• Protecting and detoxing certain hormones or chemical substances via defensive enzymes
• Active resource allocation (that means it changes and reacts depending on the environment – clever stuff!)
• Immunological protection and barrier: blocking out certain pathogens/parasites etc

A growing amount of research also suggests that how it performs its role and what it allows through has significant long term health consequences for babies. (11)

On a basic level, we know that low birth weight (and the various long term implications) is linked to placental function. (1). Preeclampsia is also a serious condition. This is linked to the placenta that has several long and short term impacts on the mother and baby. 

Ok, so we get it’s super important: so how can we give the placenta the best chance of optimal function? 

As always, there is still a lot we do not understand. Pre-eclampsia for example and why some get it vs others is complex. There are no single answers and instead likely a variety of potential causes ranging from genetics to BMI to inflammation and oxidative stress (3, 5). All contributing to the correct (or not) formation of the blood vessels crucial to the placenta’s function.

We also know that although symptoms only show later in pregnancy preeclampsia likely sets in early. It likely ‘involves poor placentation during the earliest stages of pregnancy.’ (5)

However, there are some things we do know which can help you support a developing placenta from the earliest days: 

These things can potentially help combat some of the root causes that can work against the development of a healthy placenta.

• Choline
• Melatonin
• Healthy BMI
• Omega 3 (DHA/EPA)
• Inositol
• Exercise
• N Acetyl Cysteine

We’re going to take a look at the science behind each and what you need to know:

Choline: the essential nutrient most of us haven’t heard of…   

This is a nutrient that is vastly underrated when it comes to everything pregnancy related. Research continues to mount around the role it plays across all stages of development. Everything from healthy brain development, to immune protection and supporting the placenta. Click here for much more.

When it comes to the placenta and it’s development, getting ‘enough’ appears to play a crucial role.

How does Choline (and getting enough) play a role in healthy placenta formation? 

We know the proper functioning of the placenta depends on development of a network of blood vessels that enables sufficient blood flow to the developing fetus’ (7) This is also known as Angiogenesis.

We also know that:

‘Emerging data from a growing number of studies suggests that choline supply can beneficially influence function and processes of the placenta, including angiogenesis, inflammation and macronutrient transport. (7)’

So how much do we need? 

During pregnancy the recommendation is for 450mg/day which rises to 550mg/day during breastfeeding. The good news is that it is found in many common foods – like animal protein (beef/eggs/chicken) but also mushrooms and soybeans. If you feel like you may need a supplement, always chat to your doctor first. Click here for much more.

Melatonin: how can the ‘sleep hormone’ help give our placentas a good start?! 

We are fast realising that the root cause of many issues in the body is oxidative stress and inflammation. The placenta is no exception. Click here for more in depth on this.

The quick version as to why oxidative stress/inflammation in high levels is an issue:

When the body does not have enough capacity to clean up waste/damaging factors in the body (antioxidants) we can get something called Oxidative Stress. This is where elements called free radicals form which can damage vulnerable cells. Chronic low level inflammation (where the body’s immune defence is always turned ‘on’) also contributes to cell damage. Click here for the detailed version. 

Research has increasingly linked issues with the development of the placenta to both excess oxidative stress and chronic inflammation: 

Melatonin is not only the sleep hormone, but it is also a powerful antioxidant. It also appears to be produced within the placenta itself.

‘the data overwhelmingly shows Melatonin is highly effective in reducing oxidative stress throughout the body, including in the ovary, placenta and the mother.’ (5)

In fact, it has been shown to have tangible effects in research trials, particularly over other known antioxidants like Vitamin C and E. (5)

Not only does it cross the blood-brain barrier but it also crosses the placenta and targets the major site of damaging free radical production within cells themselves: the mitochondria. On top of this, it stimulates several antioxidant enzymes and acts as an anti-inflammatory agent. (5)

Pretty powerful stuff!

So, how do we get more melatonin? 

Well first and foremost the placenta should produce its own. This is not always easy to control or straight forward. However, one of the crucial components to allow the body to produce more is known as Tryptophan.

Where to find this?

Generally speaking it is found in foods that are naturally high in protein:

• Poultry
• Nuts and seeds
• Tofu/Soy
• Milk

Prioritising healthy sleep: 

The other way of course to get systemically higher levels of melatonin is to prioritise sleep. Specifically avoiding artificial/blue light in the hours leading up to bedtime. We know that Melatonin is referred to as the ‘vampire hormone’ specifically because it only comes out in darkness. In fact, research shows that during the night melatonin is on average 10-15x higher vs daytime (5). We also know that our modern lifestyles full of artificial and even worse blue light from screens suppresses its production.

Interestingly enough (and while a connection doesn’t always = a cause) one piece of research showed that night-time circulating melatonin levels were depressed in women suffering with extreme pre-eclampsia. This has been linked to low levels of enzymes that metabolise melatonin in the body so perhaps not a simple fix. Nevertheless indicative of how this hormone can play a role protecting the placenta. (5)

Interestingly – when it comes to some of the symptoms of pre-eclampsia: hypertension (high blood pressure) we have seen external melatonin supplements ‘reduce hypertension in humans’. We know that the lowest blood pressure is at night, coinciding with the peak melatonin levels. (5)

So: put down your devices in the hours pre bedtime and prioritise getting a good 7-8hrs every night.

N.b. whilst a supplement could help for egg quality pre-pregnancy it is not recommended to take a supplement during pregnancy. If in doubt, once again always talk to your doctor.

How a healthy BMI can play a role in the placenta’s function: 

With our modern lifestyles and diets, 1/3 of reproductive age women are now classified with a BMI higher than the healthy range in the US. A considerable amount of research has shown that this is linked to many issues around conception, pregnancy and early years. It also has been shown to impact placental function and once again even influence implantation: (4)

How does a healthy BMI connect to the development of the placenta? 

One way is the production of something known as adipokines: which play a ‘significant role in creating a favourable environment for implantation and placental function.’ (4). These tend to be a lot higher when we have a higher BMI. 

Once again this relates back to inflammation – specifically too much over a long period of time – and it impacts the very earliest stages of placental development and can impact throughout pregnancy. From implantation to birth:

‘obesity alters the transcriptome of placental progenitor cells in the preimplantation and early post implantation placental precursors which is associated with later changes in placenta development and function.’ (9)

In English?

From the very first cells to divide the formation of new blood vessels (angiogensis) is impacted leading to potential issues.’ (9) It even appears to even impact the way that genes express themselves:

‘In embryo transfer studies, we found that exposure to maternal obesity prior to implantation was sufficient to result in placental dysfunction and fatal growth restriction, suggesting that the early embryonic period represents a critical window of susceptibility.’ (9)

Particularly problematic is a high fat/high sugar low protein diet (typical Western Diet)… 

Not only can the modern western diet contribute to issues that cause problems to develop, it also often leaves us lacking in crucial nutrients that can help combat some of the risk factors associated with issues developing for placentas.

Here are some that could help. (Often nutrients we don’t get enough of…)

Omega 3 fatty acids: 

We know one way to fight low level chronic inflammation (linked to issues with the placenta) is via Omega 3 fatty acids. Specifically DHA/EPA.

Interestingly enough many of us do not get ‘enough’. We also know that an imbalance in Omega 3 vs Omega 6 fatty acids (which are found in a lot of processed and fast food) is pro inflammatory, resulting in ‘marked oxidative stress in the preimplantation embryo.’ (9)

How to get more Omega 3 for your placenta? 

The quick way: eat more fatty fish – ideally low down the food chain. Think salmon, sardines, mackerel. The recommendation for pregnant women is two portions a week. Click here for more. 

If you’re thinking about a supplement the Academy of Nutrition and Dietics recommends approx 500mg/day of DHA in the prenatal diet. So that is a good starting point. If in doubt however ALWAYS ask your doctor. Algae is another source which may be worth considering. 

To read much more on Omega 3s and their role in promoting healthy pregnancy, click here. 

A connection between lack of Inositol and issues with the Placenta? 

Women with Polycystic Ovaries (PCOS) not only sometimes struggle with BMI, but also with blood sugar control which can contribute to Oxidative Stress, Inflammation and potential placental dysfunction.

Here’s the good news. Not only do we know that Inositol can help improve blood sugar control for women with PCOS (click here for more), but research shows it can help regulate endothelial function by reducing oxidative stress. (9)

What is Inositol? This is a B Vitamin. Often founds in fruits/beans/grains and nuts. However, it also comes in supplement form. If you think you may have PCOS – chat to your doctor about whether Inositol supplementation could be of benefit to you. Click here for much more detail. 

Can exercise help build a healthy placenta? 

There are obvious benefits to exercise. Helping keep a healthy BMI, helping regulate blood sugar (which can be a cause of oxidative stress and inflammation if out of balance). It has also been shown to help fight chronic inflammation when done in the right way. Click here for more. 

‘exercise can suppress inflammation which may promote placental angiogenesis’ (9).

There are however two additional potential benefits to more regular exercise:

BNDF and the placenta: 

BNDF – or brain derived neurotrophic factor – is a neurotrophic which is thought to actually play a key role in the earliest formation of the placenta. In fact lower levels of BDNF have been found in both placenta and cord blood of women with preeclampsia (9).

One way to get more BNDF? Exercise! Particularly regular resistance training. Click here for more of the ‘how to’ with our resident pre and post natal specialist Natalie Ferris.  

Apelin: 

Apelin has been considered as an exercise-induced hormone that can promote healthy blood vessel formation in the placenta. Once again, how to get more? Healthy, regular exercise. (10).

Can N-Acetyl Cysteine (NAC) help with development of a healthy placenta? 

Once again, we know that two enemies of a healthy placenta are oxidative stress and inflammation. These appear at the very root cause.

NAC is another effective antioxidant as well as being a crucial component to the body’s ultimate defender: Glutathione. Click here for more. 

This typically comes in supplement form. As always check with your doctor first. However, unlike Glutathione (which cannot generally be absorbed by the body in oral form), we know it can be absorbed. Click here for the need to know on whether or not you should chat to your doctor about an NAC supplement. 

Bottom line: 

As always, although there is a lot of science behind the things we can do to support a healthy placenta, however, in terms of what is in our control it’s not actually rocket science. A healthy, well balanced diet (click here for the science on fertility diet), lots of sleep and regular exercise can work wonders. If you feel you may need extra support in the form of supplements (Inositol, Choline, Omega 3, N Acetyl Cysteine) then chat to your doctor. Thinking about these from the earliest stages can potentially help set the stage for a healthy conception, pregnancy and early years.

References: 

1. Burton GJ, Fowden AL, Thornburg KL: Placental Origins of Chronic Disease: Physiological Reviews: American Physiology Society: 2016 Oct; 96(4): 1509-1565
2. Morrison JL, Regnault TR: Nutrition in Pregnancy: Optimising Maternal Diet and Fetal Adaptions to Altered Nutrient Supply: MDPI Nutrients: 8(6): 2016 Jun
3. Devarshi PP, Grant RW, Ikonte C: Maternal Omega-3 Nutrition, Placental Transfer and Fetal Brain development in Gestational Diabetes and Preeclampsia: MDPI Nutrients: 11(5) 2019
4. Howell KR, Powell TL: Effects of maternal obesity on placental function and fetal development: Reproduction: Mar: 2017: 153(3)
5. Gustavo de Almeida C, Lupi LA, Cucielo M: Melatonin Promotes Uterine and Placental Health: Potential Molecular Mechanisms: International Journal of Molecular Science: 2019 Dec.
6. Gerri C, McCarthy A, Alanis-Loboto: Initiation of a conserved trophectoderm program in human, cow and mouse embryos: Nature: September 2020 
7. Korsmo HW, Jiang X, Caudil A: Choline: Exploring the Growing Science and it’s benefits: MDPI Nutrients: 2019 Aug: 11(8)1823
8. Spencer RN, Carr DJ, David AL: Treatment of poor placentation and the prevention of associate adverse outcomes – what does the future hold? Prenatal Diagnosis: 2014 Jul; 34(7): 677-684
9. Stuart TJ, O’Neill K: Diet-induced obesity alters the maternal metabolome and early placenta transcriptome and decreases placenta vascularity in the mouse: Biology of Reproduction: 2018, 98(6) 795-809
10. Son JS, Liu X, Tian Q: Exercise prevents the adverse effects of maternal obesity on placental vascularisation and fetal growth: Journal of Physiology: 597.13 (2019) 3333-3347
11. Sferruzzi-Perri AN, Camm EJ: The programming power of the Placenta: Frontiers of Physiology: March 2016. 

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