{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T12:46:35Z","timestamp":1765111595722,"version":"3.46.0"},"reference-count":69,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UG3 OD035543"],"award-info":[{"award-number":["UG3 OD035543"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Resistance to blood flow in the maternal uterine artery (UtA) has been associated with both preeclampsia (PE) and small\u2010for\u2010gestational age (SGA). Our objective was to assess the association of increased maternal UtA resistance with child neurodevelopmental and behavioral outcomes in low\u2010risk pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Serial ultrasound exams were prospectively performed in 2334 racial and ethnically diverse, healthy patients with low\u2010risk singleton pregnancies (July 2009 to Jan 2013) as part of the NICHD\u2010Fetal Growth Studies. Maternal UtA Dopplers were performed between 18w0d and 25w6d and pregnancy outcomes were collected at delivery including the occurrence of PE and SGA birthweight. Mother\u2013child pairs from the original study were re\u2010recruited to the NIH\u2010Environmental Influences on Child Health Outcomes (ECHO) Study (May 2017 to April 2019). Analysis of neurodevelopment was performed using age\u2010appropriate versions of the NIH Toolbox for children including executive (inhibitory control\/attention, cognitive flexibility, and working memory) and motor domains (dexterity, grip strength, and standing balance). Assessment of behavioral problems was obtained by parent report using the Child Behavioral Checklist. Multivariable adjusted general linear and logistic regression models were used to determine the mean difference in standardized test scores of observed child executive and motor functions and parent\u2010reported child behaviors associated with a 1\u2010standard deviation (SD) increment in UtA pulsatility index (PI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 675 patients had both interrogation of mid\u2010pregnancy UtA Dopplers and at least one measure of executive or motor domain function or parent\u2010reported behavior between the ages of 4 and 8 years. Each 1\u2010SD increase in UtA PI was associated with a significant reduction in cognitive flexibility in children aged 4\u20137 years (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0457; adjusted mean difference[aMD] \u22120.97; 95% CI \u22121.8, \u22120.14). There were no associations between motor function and increased UtA resistance. A 1\u2010SD increase in UtA PI was not associated with any increased parent report of child behavioral problems. A 1\u2010SD increase in UtA PI was associated with a 1.5\u2010fold increased risk of PE. In mediation analyses, differences in executive function domains associated with increased UtA PI Doppler findings were not explained by either maternal PE, SGA, or birthweight\n                      <jats:italic>z<\/jats:italic>\n                      \u2010scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Increased maternal mid\u2010pregnancy UtA resistance appears to be associated with small decreases in executive domain function (cognitive flexibility) but not motor domain function. In this exploratory study, the observed effect sizes were modest and the clinical implications are uncertain, but they suggest the possibility of long\u2010term neurodevelopmental effects of subclinical placental dysfunction in low\u2010risk pregnancies. The findings, however, are biologically plausible and contribute to a growing body of literature exploring antenatal predictors of child neurodevelopment. Larger confirmatory studies will be needed to determine if maternal UtA resistance can contribute to the early identification of at\u2010risk children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Clinicaltrials.gov identifiers: NCT00912132, NCT03266198<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70076","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T03:19:53Z","timestamp":1754018393000},"source":"Crossref","is-referenced-by-count":0,"title":["Mid\u2010pregnancy uterine artery Dopplers and child neurodevelopment"],"prefix":"10.1002","volume":"1","author":[{"given":"Eliza R.","family":"McElwee","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seonjoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Psychiatry Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Babineau","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela L.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly J.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine L.","family":"Grantz","sequence":"additional","affiliation":[{"name":"Senior Investigator, Epidemiology Branch, Division of Population Health Research, Division of Intramural Research  <i>Eunice Kennedy Shriver<\/i> National Institute of Child Health and Human Development, National Institute of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Grobman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Warren Alpert Medical School of Brown University  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald J.","family":"Wapner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel W.","family":"Skupski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology New York Presbyterian Queens Hospital  Queens New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Sciscione","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Drexel University College of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah A.","family":"Wing","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Fountain Valley Regional Hospital and Medical Center  Fountain Valley California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Nageotte","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of California  Irvine California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward K.","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Brown University School of Medicine  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan T.","family":"Tita","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine, Department of Obstetrics and Gynecology University of Alabama  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Tak\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Psychology, Faculty of Arts Charles University  Prague Czech Republic"},{"name":"Department of Gynecology and Obstetrics Bulovka University Hospital and the First Faculty of Medicine Charles University  Prague Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Monk","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Psychiatry Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger B.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Centers Control for D.National Center on Birth Defects and Developmental Disabilities (NCBDDD) Making a Difference Across the Lifespan. Inclusion Accessibility and Equity for All. Fiscal Year 2021 Annual Report.;2021."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.03.027"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00020-R"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372\u2010018\u20100287\u20104"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.0306"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP271402"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.03.037"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.06.014"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20350"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4057"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2353\/ajpath.2007.070006"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1976"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.06.054"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2005.00519.x"},{"issue":"2","key":"e_1_2_8_17_1","first-page":"277","article-title":"Systolic or Diastolic Notch in Uterine Artery Blood Flow Velocity Waveforms in Hypertensive Pregnant Patients: Relationship to Outcome","volume":"80","author":"Thaler I.","year":"1992","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2017.27"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyx161"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.10.098"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000345"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972\u20102327.138464"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/mono.12035"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/nprot.2006.46"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2003.12.01"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2022.2027584"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00469"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.2466\/pms.2000.90.3.823"},{"volume-title":"Manual for the Child Behavior Checklist\/4-18 and 1991 profile","year":"1991","author":"Achenbach T. M.","key":"e_1_2_8_29_1"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102850.2011.01743.x"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579417000992"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579400003114"},{"volume-title":"Manual for the ASEBA Preschool Forms and Profiles","year":"2000","author":"Achenbach T. M.","key":"e_1_2_8_33_1"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.15.09087"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2022.03.021"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.7748\/mhp.7.5.27.s25"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010014\u20100284\u2010x"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2017.52"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2022.2038853"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1131"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.813343"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17515"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13358"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2010.29.7.1103"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010031197"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2019.1666094"},{"volume-title":"National Institutes of Health Toolbox Cognition Battery (NIH Toolbox CB): Validation for Children between 3 and 15 Years","year":"2013","author":"Zelazo P. D.","key":"e_1_2_8_47_1"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200060"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13414\u2010016\u20101140\u20105"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/desc.13283"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0033622"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/mono.12037"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dr.2015.09.001"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3500\u201009.2010"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u2010001040"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2021.01.004"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.03.001"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2022.07.014"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.11\u2010191916"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9008"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6249"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.05.043"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11112"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002708"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0275129"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14818"},{"volume-title":"Handbook of Child Psychology","year":"2006","author":"Damon W.","key":"e_1_2_8_67_1"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001648\u2010199001000\u201000010"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2011.08.010"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1177\/003591576505800503"}],"container-title":["Pregnancy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmf2.70076","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T12:41:00Z","timestamp":1765111260000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pmf2.70076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":69,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/pmf2.70076"],"URL":"https:\/\/doi.org\/10.1002\/pmf2.70076","archive":["Portico"],"relation":{},"ISSN":["2997-9684","2997-9684"],"issn-type":[{"type":"print","value":"2997-9684"},{"type":"electronic","value":"2997-9684"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"article-number":"e70076"}}