Cellular cholesterol uptake is mainly mediated by the LDL receptor (LDL-R) and the scavenger receptor family. We hypothesized that expression levels of key receptors of these families were regulated differently in placentas from IUGR pregnancies with varying degrees of severity. Third-trimester placentas from IUGR pregnancies with (IUGR-S) and without (IUGR-M) fetal hemodynamic changes and from control (AGA) pregnancies were studied. LDL-R, LDL-Rrelated protein (LRP-1), and scavenger receptor class B type I (SR-BI) mRNA and protein levels were measured. Cholesterol concentration and composition of lipoproteins were analyzed enzymatically and by lipid electrophoresis, respectively, in maternal and umbilical cord blood. LDL-R mRNA levels in IUGR-M were similar to AGA but lower (P Ͻ 0.05) in IUGR-S. In contrast, LDL-R protein was twofold (IUGR-M) and 1.8-fold (IUGR-S) higher (P Ͻ 0.05) than in the AGA group. LRP-1 mRNA and protein levels were not altered in the IUGR cases. SR-BI mRNA was unchanged in IUGR, but protein levels were lower (P Ͻ 0.05) in IUGR-S than in the other groups. Maternal plasma concentrations of LDL cholesterol were higher (P Ͻ 0.05) in the AGA group (188.5 Ϯ 23.6 mg/dl) than in the IUGR-S group (154.2 Ϯ 26.1). Electrophoretic mobility of the LDL fraction in maternal plasma demonstrated significant changes in migration toward higher values (AGA 0.95 Ϯ 0.06, IUGR-M 1.12 Ϯ 0.11, P Ͻ 0.001; IUGR-S 1.28 Ϯ 0.20, P ϭ 0.002). We conclude that LDL-R and SR-BI levels are altered in IUGR pregnancies. These differences were associated with changes in LDL, but not HDL, mobility and cholesterol concentration in maternal circulation. pregnancy; placenta; lipids; fetal growth CHOLESTEROL HAS MULTIPLE BIOLOGICAL ROLES that include its functioning as a structural membrane component, precursor for steroid synthesis, and activator of various cellular processes (42). Extensive steroid hormone synthesis in the placenta and the rapid growth and development of the fetus make pregnancy a condition of high cholesterol demand in the feto-placental unit (23). In humans, both placental tissue (39) and fetal organs (5) have the capacity for de novo cholesterol synthesis. However, the high cholesterol demand in the fetal tissues may not be fully satisfied by endogenous means. A significantly higher cholesterol concentration in the umbilical vein compared with the arteries (33) suggests transfer from maternal or placental sources to the fetus. In the third trimester of gestation, maternally-derived cholesterol reportedly contributes ϳ22-40% to the fetal cholesterol pool (14, 24). However, this remains controversial (25). The molecular mechanisms accounting for the uptake of maternal cholesterol into the placenta, mainly as lipoprotein-associated cholesterol (42), and for subsequent transfer, if any, into the fetal circulation, are as yet poorly understood.Cellular uptake of maternal low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL) is mainly mediated by two receptor familie...