{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:10:40Z","timestamp":1785499840806,"version":"3.56.0"},"reference-count":48,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T00:00:00Z","timestamp":1422316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2015,2]]},"abstract":"ABSTRACT<\/jats:title>Objective<\/jats:title>To investigate whether signs of placental underperfusion (PUP<\/jats:styled-content>), defined as any maternal and\/or fetal vascular pathology, confer an increased risk of neonatal morbidity in late\u2010onset small\u2010for\u2010gestational\u2010age (SGA<\/jats:styled-content>) fetuses with normal umbilical artery (UA<\/jats:styled-content>) Doppler indices.<\/jats:p><\/jats:sec>Methods<\/jats:title>A cohort of 126 SGA<\/jats:styled-content> singleton fetuses with normal UA<\/jats:styled-content> Doppler indices that were delivered after 34 weeks' gestation was studied. For each case, the placenta was evaluated histologically for signs of PUP<\/jats:styled-content> using a hierarchical and standardized classification system. Neonatal morbidity was assessed according to the score calculated from the morbidity assessment index for newborns (MAIN<\/jats:styled-content>), a validated outcome scale. The independent association between PUP<\/jats:styled-content> and neonatal morbidity was evaluated using multivariable median regression analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>In 84 (66.7%) placentae, 97 placental histological findings that qualified as signs of PUP<\/jats:styled-content> were observed. These PUP<\/jats:styled-content> cases had a significantly higher incidence of emergency Cesarean section for non\u2010reassuring fetal status (44.1% vs<\/jats:italic> 21.4%, respectively; P<\/jats:italic>\u2009=\u20090.013) and neonatal metabolic acidosis at birth (33.3% vs<\/jats:italic> 14.3%, respectively; P<\/jats:italic>\u2009=\u20090.023), than did those without PUP<\/jats:styled-content>. The median MAIN<\/jats:styled-content> score differed significantly between those with PUP<\/jats:styled-content> and those without (89 vs<\/jats:italic> 0, respectively; P<\/jats:italic>\u2009=\u20090.025). This difference remained significant after adjustment for potential confounders. The proportion of cases with scores indicative of mild to severe morbidity was also significantly higher in the PUP<\/jats:styled-content> group (31% vs<\/jats:italic> 14.3%, respectively; P<\/jats:italic>\u2009=\u20090.043).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In late\u2010onset SGA<\/jats:styled-content> fetuses with normal UA<\/jats:styled-content> Doppler indices, signs of PUP<\/jats:styled-content> imply a higher neonatal morbidity. These findings allow the phenotypic profiling of fetal growth restriction among the general population of late\u2010onset SGA<\/jats:styled-content>. Copyright \u00a9 2014 ISUOG. Published by John Wiley & Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13415","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T11:29:31Z","timestamp":1400844571000},"page":"149-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Correlation between histological signs of placental underperfusion and perinatal morbidity in late\u2010onset small\u2010for\u2010gestational\u2010age fetuses"],"prefix":"10.1002","volume":"45","author":[{"given":"M.","family":"Parra\u2010Saavedra","sequence":"first","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine, Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic\u2010IDIBAPS University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"},{"name":"Maternal\u2010Fetal Unit CEDIFETAL, Centro de Diagn\u00f3stico de Ultrasonido e Im\u00e1genes, CEDIUL Barranquilla Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Simeone","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine, Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic\u2010IDIBAPS University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"},{"name":"High Risk Pregnancy Unit, Department of Child and Women's Health Careggi University Hospital\u2010Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Triunfo","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine, Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic\u2010IDIBAPS University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"},{"name":"Department of Obstetrics and Gynecology Catholic University of the Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Crovetto","sequence":"additional","affiliation":[{"name":"Department of Maternal\u2010Fetal Medicine, Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic\u2010IDIBAPS University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona Spain"},{"name":"Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Dipartimento Ostetricia e Ginecologia Universit\u00e0 degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Botet","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute Cl\u00ednic of Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic\u2010IDIBAPS University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER) Barcelona 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