Placenta最新文献

{"title":"Stillbirth at term in Iceland: Causes of death and patterns of placental injury","authors":"Ragnheidur I. Bjarnadottir ,&nbsp;Thora Steffensen ,&nbsp;Karin Pettersson ,&nbsp;Nikos Papadogiannakis ,&nbsp;Alexander K. Smarason ,&nbsp;Johanna Gunnarsdottir","doi":"10.1016/j.placenta.2025.02.007","DOIUrl":"10.1016/j.placenta.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Iceland is a high-income country with &lt;400.000 inhabitants and low stillbirth rate (SBR). Increased antenatal risk assessment and interventions in high-risk pregnancies doubled the induction rate after 2008.</div></div><div><h3>Objective</h3><div>Estimate the SBR at term, comparing an earlier (1996–2008) and latter (2009–2021) 13-year period, and describe causes of death and patterns of placental injury of infants stillborn at term.</div></div><div><h3>Study design</h3><div>Stillbirth at term was defined as antepartum or intrapartum death of an infant that was diagnosed after ≥37 weeks of gestation. All cases (n = 125) had placental examination. Histopathological slides were reviewed, and pattern of placental injury classified according to the Amsterdam consensus. Medical records were found for all mothers who had stillbirth at term and cause of death assigned according to the Stockholm classification of stillbirth.</div></div><div><h3>Results</h3><div>No decrease in the SBR at term was found between periods. Majority of deaths (72 %) were caused by cord complications and/or placental insufficiency and deaths attributed to placental insufficiency increased in the latter period. Placentas weighing under the 10th percentile were more common in the latter period, 43.5 % vs. 30.2 % (p &lt; 0.05) as was chronic villitis of unknown etiology (VUE), 40.3 % vs. 12.7 % (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Stillbirth at term has not decreased in Iceland, despite increased antenatal surveillance and induction rate, with more deaths attributed to placental insufficiency and VUE increasingly found in the later period. Further research is needed on the correlation of patterns of placental injury with clinical phenotypes of mothers and infants.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 14-19"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research design and tissue collection considerations for investigation of placenta accreta spectrum.","authors":"Stacy Zamudio, Nicholas P Illsley","doi":"10.1016/j.placenta.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.02.006","url":null,"abstract":"<p><p>Placenta accreta spectrum (PAS) is a group of pregnancy pathologies characterized by loss/absence of decidua and trophoblast over-invasion penetrating into the myometrium beyond the normal depth. It is associated with expansion of deeper branches of the uterine arteries and placental adherence to the uterus. Undetected PAS leads frequently to massive and potentially fatal hemorrhage at delivery. For the more severe forms of PAS (increta, percreta), the most frequent solution is caesarean delivery-hysterectomy. The etiology of PAS is, however, unclear at best. While there is increasing research interest, the clinical intricacies of this pathology pose significant challenges for the researcher. In this communication we present the elements which we believe should be considered when undertaking (or interpreting) research into PAS, particularly when biological samples and molecular techniques are involved.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary trophoblastic deportation in the hystricomorph rodent Lagostomus maximus","authors":"Francisco Acuña ,&nbsp;Gimena Gomez Castro ,&nbsp;Daniel González Gómez ,&nbsp;Agostina Terraza ,&nbsp;Mirta Alicia Flamini ,&nbsp;Claudio Gustavo Barbeito","doi":"10.1016/j.placenta.2025.02.004","DOIUrl":"10.1016/j.placenta.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Trophoblast has been reported in the lungs of gestating eutherian mammals with hemochorial placenta, including humans, cotton rats, and American hares. This study describes the discovery of trophoblastic-like cells in the lungs of <em>Lagostomus maximus</em>.</div></div><div><h3>Methods</h3><div>Lung and placenta samples from non-pregnant and pregnant plains viscachas were analyzed using histology and immunohistochemistry.</div></div><div><h3>Results</h3><div>Macroscopically, the lungs of females in both groups showed no alterations, but microscopic examination of the lungs from pregnant females revealed lesions and trophoblast-like cells. Markers such as pancytokeratin, MMP-2, MMP-9, and progesterone receptors were found in both pulmonary trophoblastic cells and the various types of trophoblasts in the placenta and subplacenta. Notably, cytokeratin-7 showed similarity with the placenta but not with the subplacenta. Cells identified in the lungs that were positive for markers similar to trophoblast giant cells in the maternal blood chambers suggest that the trophoblast that reaches the lungs may originate from giant cells that enter maternal blood circulation rather than those that invade the uterine artery. Immunohistochemical analysis indicated that, unlike placental trophoblast, the lung cells exhibited no proliferative activity.</div></div><div><h3>Discussion</h3><div>The lack of this process in mice and the difficulty of developing <em>in vivo</em> experimental models have prompted the exploration of <em>in vitro</em> models. <em>L. maximus</em> may serve as an alternative model to study this process, necessitating further research to determine the timing of this phenomenon during gestation and whether pulmonary alterations persist after parturition.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coagulation and fibrinolytic system of umbilical venous blood in hyper-coiled umbilical cord: A single center cohort study","authors":"Shota Saji ,&nbsp;Masatomo Doi ,&nbsp;Junki Koike ,&nbsp;Nao Suzuki ,&nbsp;Junichi Hasegawa","doi":"10.1016/j.placenta.2025.02.003","DOIUrl":"10.1016/j.placenta.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to clarify whether the coagulation-fibrinolytic system is activated in a hyper-coiled umbilical cord (HCC).</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted at a single perinatal center in Japan, including singleton pregnant women who delivered after 37 weeks of gestation between January and July 2024. Umbilical venous blood was collected immediately after birth and before placental delivery. The coagulation and fibrinolytic systems were measured, and variables were compared between patients with and without HCC.</div></div><div><h3>Results</h3><div>As a variable of cell blood count and hemostatic function, platelet concentration was significantly lower in the HCC group [median (range): 25.5 (17.3–32.1) vs 30.4 (18.5–39.55) x100000/μl, p = 0.020]. For coagulation variables, fibrinogen concentration [105 (63–116) vs 137.5 (56–229) mg/dl, p &lt; 0.001] and antithrombin III [35 (27–51) vs 47.5 (31–62) %, p = 0.022] were significantly lower in the HCC group. Regarding fibrinolytic variables, plasmin inhibitor complex concentration was significantly higher in HCC group [1.3 (1.0–6.9) vs 0.7 (0.3–5.2) μg/ml, p = 0.036]; however, plasminogen concentration was significantly lower in HCC group [40 (32–46) vs 50 (25–64), p &lt; 0.001].</div></div><div><h3>Discussion</h3><div>This is the first report where the coagulation-fibrinolytic system in the umbilical venous blood in cases with HCC was demonstrated. Findings reveal an activated coagulation-fibrinolytic system even in cases without severe fetal growth restriction due to HCC after 37 weeks of gestation.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"162 ","pages":"Pages 9-13"},"PeriodicalIF":3.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of semen inflammation on embryo implantation, placentation, pregnancy outcomes and offspring health.","authors":"María S Martinez, Yair A Chocobar, Yamila Fariz, Daniela A Paira, Virginia E Rivero, Rubén D Motrich","doi":"10.1016/j.placenta.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.02.002","url":null,"abstract":"<p><p>This review explores the critical role of semen inflammation in sperm quality, embryo implantation, placentation, and its broader implications on reproductive health. Chronic inflammation of the male genital tract has been increasingly recognized as a significant factor contributing to infertility. This inflammation not only impairs semen quality but also disrupts the intricate immune cross-talk between the male and female genital tracts, which is essential for successful implantation, placentation and pregnancy. The review synthesizes existing research on the mechanisms by which inflammatory mediators in semen influence the female immune environment, leading to altered uterine receptivity, placental formation, and embryo implantation. Furthermore, the impact of these disruptions on the health and development of the offspring is discussed, highlighting the transgenerational effects of male genital tract inflammation. Through an examination of both animal models and human studies, this review underscores the need for a deeper understanding of the immune interactions in reproductive biology and the potential for novel therapeutic interventions aimed at mitigating the adverse outcomes associated with semen inflammation.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrative stress-induced dysregulation of placental AQUAPORIN-9: A potential key player in preeclampsia pathogenesis.","authors":"Yollyseth Medina, Nazarena Fernandez, Matías N Sierra, Mauricio Castro Parodi, Alicia E Damiano","doi":"10.1016/j.placenta.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.02.001","url":null,"abstract":"<p><p>Preeclampsia is associated with increased oxidative and nitrative stress, resulting in elevated protein nitration and potential functional impairment. Previously, we found an increased expression of AQP9 protein with a loss of function in preeclamptic placentas. However, the link between nitrative stress and AQP9 has not yet been explored. Here, we aimed to evaluate the effect of nitrative stress on placental AQP9 and its role in the pathogenesis of preeclampsia. In silico analysis was conducted on the amino acid sequences of AQP9 to identify potential nitration sites. Levels of 3NyT-AQP9 were assessed by immunoprecipitation in normal and preeclamptic placentas. AQP9 expression and function were evaluated by culturing normal placental explants with 0, 25, 50, 100, and 200 μM ONOO- to induce nitrative stress. Viability and integrity of the explants and stress markers were determined. Water uptake and utilization of lactate mediated by AQP9 were studied along with the molecular expression of AQP9 and 3-NyT-AQP9. The in silico analysis showed that AQP9 is more susceptible to nitration than other AQPs. The abundance of nitrated AQP9 significantly increased in preeclamptic placentas compared to normal ones (n = 4; p < 0.05). Peroxynitrite treatment also increased AQP9 protein expression without altering its gene expression and impaired the transport of water and lactate mediated by this protein. Our findings provide evidence that nitrative stress induces the nitration of AQP9 protein, leading to the accumulation of a non-functional protein in the syncytiotrophoblasts. Therefore, this altered protein may play a pivotal role in the pathogenesis of preeclampsia by disrupting cellular homeostasis.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced SMEK1 regulates trophoblast migration and invasion in fetal growth restriction","authors":"Anna Li ,&nbsp;Man Zhao ,&nbsp;Ziming Lin ,&nbsp;Zexin Yang ,&nbsp;Pihai Gong ,&nbsp;Chunying Wang ,&nbsp;Zhenya Fang ,&nbsp;Meihua Zhang","doi":"10.1016/j.placenta.2025.02.005","DOIUrl":"10.1016/j.placenta.2025.02.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Fetal growth restriction (FGR) is a significant pregnancy condition characterized by the fetus failing to attain its full genetic growth potential. FGR is primarily ascribed to defective placentation, owing to impaired trophoblast cellular function. The objective of this research is to elucidate the pathogenic functions of suppressor of Mek1 (SMEK1) in FGR.</div></div><div><h3>Methods</h3><div>Western blot and Immunofluorescence were used to detect the expression and localization of SMEK1 in placenta. We overexpressed and knocked down SMEK1 using plasmid or siRNA special targeted it. EdU Assay, flow cytometry, Western blot, Wound healing migration and Transwell insert assay were used to detect the influence of SMEK1 on cellular function. The mechanism of SMEK1 in regulating the migration of JEG3 cells was predicted by employing transcriptomics and bioinformatics analysis, and was validated by Western blot.</div></div><div><h3>Results</h3><div>The expression of SMEK1 was downregulated in FGR placentas. The aberrant expression of SMEK1 in JEG3 cells is associated with cell migration and invasion, but not with proliferation, or apoptosis. Transcriptomic analysis and Western blots indicate that knockdown of SMEK1 inhibited the PI3K/Akt/mTOR pathway. A significant inhibition was observed in the epithelial-mesenchymal transition (EMT) process of JEG3 cells within the SMEK1 knockdown group. The activation of the PI3K/Akt/mTOR pathway partially restored the impaired migration and invasive ability due to SMEK1 knockdown in JEG3 cells.</div></div><div><h3>Discussion</h3><div>the reduction of SMEK1 may contribute to the development of FGR by hindering the EMT process of trophoblast cells through modulation of the PI3K/Akt/mTOR signaling pathway.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"161 ","pages":"Pages 65-75"},"PeriodicalIF":3.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consequences of the modulation of gestational resistance training intensity for placental cell composition and nutrient transporter expression","authors":"Thaynan Raquel dos Prazeres Oliveira ,&nbsp;Débora Priscila Lima-Oliveira ,&nbsp;Maira Beatriz Matos de Paula ,&nbsp;Rafael Victor Lira Brito ,&nbsp;Alvaro Nascimento Barreto ,&nbsp;Alluanan Adelson do Nascimento Silva ,&nbsp;Fernanda Carolina Ribeiro Dias ,&nbsp;Valdemiro Amaro da Silva-Junior ,&nbsp;Osmar Henrique Dos Santos-Junior ,&nbsp;Claudia Jacques Lagranha ,&nbsp;Kelli Nogueira Ferraz-Pereira ,&nbsp;José Antonio-Santos ,&nbsp;Raquel Da Silva Aragão","doi":"10.1016/j.placenta.2025.01.012","DOIUrl":"10.1016/j.placenta.2025.01.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Resistance training during pregnancy provides benefits for the mother and fetus, but little is known about the effects of resistance training on placental structure and function or the repercussions of modifying resistance training intensity on the mother-fetus-placenta triad.</div></div><div><h3>Methods</h3><div>Female Wistar rats were submitted to resistance training involving a ladder climb (80 % of maximum load carried (MLC), 5-day/week for 3-weeks) before pregnancy. After confirmation of mating, the rats were randomly divided into three groups, according to resistance training intensity during pregnancy: constant-intensity training (CIT, trained at 80 % of MLC through gestation), decreasing-intensity training (DIT, 80 % of MLC during first and second weeks of gestation and 50 % of MLC in the third week), and undulating-intensity training (UIT, 50 % of MLC in the first and third weeks, and 80 % of MLC in the second week). A control group did not undergo any training. Samples were collected on gestational day 20.</div></div><div><h3>Results</h3><div>Resistance training had no impact on maternal body weight, muscle glycogen content, adipocyte morphology, number of fetuses, number of absorptions, placental area, or fetal growth parameters. The CIT group presented lower maternal serum glucose. The UIT group presented increased presence of fetal capillaries in the labyrinth zone and increased <em>Glut1</em>, <em>Glut3</em>, and <em>Snat1</em> expression in the placenta. <em>Snat2</em> expression was upregulated in all resistance training groups and higher levels of <em>Mtor</em> expression were found in the DIT group. <em>Il1b</em> expression increased in the CIT group, and higher levels of <em>Il10</em> expression were found in the DIT and UIT groups.</div></div><div><h3>Discussion</h3><div>Resistance training was safe for pregnant rats. Its influence on glucose and amino acid transport was not dependent on changes in <em>Mtor</em> expression and did not impact fetal growth.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"161 ","pages":"Pages 55-64"},"PeriodicalIF":3.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143232089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ferumoxytol-enhanced MRI of retroplacental clear space disruption in placenta accreta spectrum","authors":"Andrew A. Badachhape ,&nbsp;Brian Burnett ,&nbsp;Prajwal Bhandari ,&nbsp;Laxman Devkota ,&nbsp;Rohan Bhavane ,&nbsp;Renuka Menon ,&nbsp;Mayank Srivastava ,&nbsp;Hennie Lombaard ,&nbsp;Amir Shamshirsaz ,&nbsp;Ketan B. Ghaghada ,&nbsp;Karin A. Fox ,&nbsp;Ananth V. Annapragada","doi":"10.1016/j.placenta.2024.12.026","DOIUrl":"10.1016/j.placenta.2024.12.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Placenta accreta spectrum (PAS) occurs when the placenta is pathologically adherent to the myometrium. An intact retroplacental clear space (RPCS) is a marker of normal placentation. In this study, we investigate use of the FDA-approved iron supplement ferumoxytol for contrast-enhanced MRI of the RPCS in mouse models of normal pregnancy and PAS. We then demonstrate the translational potential of this technique in human patients (n = 6) presenting with severe PAS (FIGO Grade 3C), moderate PAS (FIGO Grade 1), and no PAS.</div></div><div><h3>Methods</h3><div>T1-weighted sequences were used to determine the optimal dose of ferumoxytol in pregnant mice. Pregnant Gab3^−/− mice which demonstrate adherent placentation were imaged alongside wild-type (WT) pregnant mice with non-adherent placentation. Fe-MRI was also performed in 6 pregnant subjects using standard T1 and T2 weighted sequences and a 3D magnetic resonance angiography (MRA) sequence.</div></div><div><h3>Results</h3><div>Ferumoxytol administered at 5 mg/kg led to strong placental enhancement in Fe-MRI images. Gab3^−/− mice demonstrated loss of the hypointense region characteristic of the RPCS relative to WT mice. In human patients, Fe-MRI enabled high uteroplacental vasculature signal and quantification of the volume and signal profile in severe and moderate invasion of the placenta relative to non-PAS cases.</div></div><div><h3>Discussion</h3><div>Ferumoxytol, an FDA-approved iron oxide nanoparticle formulation, enabled T1w MRI visualization of abnormal vascularization and loss of uteroplacental interface in a murine model of PAS. The potential of this non-invasive visualization technique was then further demonstrated in human subjects and suggests the possibility of PAS diagnosis using contrast enhanced MRI.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"160 ","pages":"Pages 100-106"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between abnormal fetoplacental Dopplers, angiogenic markers of placental dysfunction and adverse perinatal outcomes in diabetic pregnancies with small fetuses – A prospective study","authors":"Jesrine Hong ,&nbsp;Kylie Crawford ,&nbsp;Erika Cavanagh ,&nbsp;Vicki Clifton ,&nbsp;Fabricio da Silva Costa ,&nbsp;Anthony V. Perkins ,&nbsp;Sailesh Kumar","doi":"10.1016/j.placenta.2024.12.025","DOIUrl":"10.1016/j.placenta.2024.12.025","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to evaluate differences in circulating maternal placental biomarkers and fetoplacental Dopplers in women with diabetes mellitus in pregnancy (DIP) with prenatally identified small fetuses (defined as &lt;20th centile for gestational age) compared to women with small fetuses without DIP.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study of women with DIP with small infants compared to a non-diabetic cohort with similarly small fetuses. Multivariable logistic regression was used to evaluate the effect of DIP on placental biomarkers, fetoplacental Dopplers, and adverse perinatal outcomes.</div></div><div><h3>Results</h3><div>There were 447 pregnancies in this study – 117 (26.2 %) had DIP and 330 (73.8 %) did not have diabetes. Of the DIP cohort, 57 (48.7 %) had early-onset and 27 (23.1 %) had late-onset FGR. Higher rates of low PlGF levels&lt;100 ng/L (42.1 % vs. 25.7 %,p = 0.002), high sFlt-1/PlGF ratio (39.6 % vs. 25.4 %,p = 0.006), low MCA PI &lt; 5th centile at recruitment (18.8 % vs. 7.6 %,p &lt; 0.001, OR 2.37 95%CI 1.25, 4.46,p = 0.008), abnormal UA Doppler before delivery (OR 1.63 95%CI 1.00, 2.66,p = 0.048) were seen in the DIP cohort. DIP was associated with higher rates of emergency cesarean section (43.6 % vs. 26.7 %,p = 0.001) and lower birthweight (2300 (1558, 2610g) vs. 2447 (2050, 2690g),p = 0.003). The odds of early FGR (OR 1.90 95%CI 1.20, 2.98,p = 0.006), PTB&lt;37 weeks (OR 1.66 95%CI 1.02, 2.70,p = 0.039), PTB&lt;34 weeks’ gestation (OR 3.00 95%CI 1.51, 5.96,p = 0.002), composite non-neurological neonatal morbidity (OR 1.86 95%CI 1.04, 3.33,p = 0.037), and hypoglycemia (OR 3.69 95%CI 1.59, 8.54,p = 0.002) were significantly higher in DIP.</div></div><div><h3>Conclusions</h3><div>DIP is associated with increased risks of early-onset FGR, PTB, composite severe non-neurological neonatal morbidity, and neonatal hypoglycemia in women with small infants. DIP was significantly associated with increased odds of MCA PI &lt; 5th centile at diagnosis and abnormal UA Doppler before birth.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"160 ","pages":"Pages 51-59"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}