The developing human fetus is able to cope with the physiological reduction in oxygen supply occurring in utero. However, it is not known if microvascularization of the fetus is augmented when pregnancy occurs at high altitude. Fifty-three healthy term newborns in Puno, Peru (3,840 m) were compared with sea-level controls. Pre- and postductal arterial oxygen saturation (SpO2) was determined. Cerebral and calf muscle regional tissue oxygenation was measured using near infrared spectroscopy (NIRS). Skin microcirculation was noninvasively measured using incident dark field imaging. Pre- and postductal SpO2 in Peruvian babies was 88.1 and 88.4%, respectively, which was 10.4 and 9.7% lower than in newborns at sea level (P < 0.001). Cerebral and regional oxygen saturation was significantly lower in the Peruvian newborns (cerebral: 71.0 vs. 74.9%; regional: 68.5 vs. 76.0%, P < 0.001). Transcutaneously measured total vessel density in the Peruvian newborns was 14% higher than that in the newborns born at sea level (29.7 vs. 26.0 mm/mm(2); P ≤ 0.001). This study demonstrates that microvascular vessel density in neonates born to mothers living at high altitude is higher than that in neonates born at sea level.
El Niño–Southern Oscillation has been treated as a disruptor of environmental and socioeconomic equilibrium both in ancient times and in modern-day Peru. Recent work in the coastal desert plain, known as the Pampa de Mocan, challenges this view by demonstrating that prehispanic irrigation systems were designed to incorporate floods and convert them into productive waters. Archaeological investigations in this landscape reveal a 2,000-y history of floodwater farming embedded in conventional canal systems. Together with a pollen record recovered from a prehispanic well, these data suggest that the Pampa de Mocan was a flexible landscape, capable of taking advantage of El Niño floodwaters as well as river water. In sharp contrast to modern-day flood mitigation efforts, ancient farmers used floodwaters to develop otherwise marginal landscapes, such as the Pampa de Mocan, which in turn mitigated risk during El Niño years. These archaeological data speak to contemporary policy debates in the face of increasingly intense and frequent natural disasters and question whether El Niño Southern Oscillation events should be approached as a form of temporary disorder or as a form of periodic abundance.
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