{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:08:52Z","timestamp":1792894132091,"version":"4.5.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"crossref","award":["8UL1TR000105,U01-HD045954 ,U01-HD087182 ,U10-HD045925 ,U10-HD045944,U10-HD045952 ,U10-HD045953 ,U10-HDO45955"],"award-info":[{"award-number":["8UL1TR000105,U01-HD045954 ,U01-HD087182 ,U10-HD045925 ,U10-HD045944,U10-HD045952 ,U10-HD045953 ,U10-HDO45955"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Delta-like homolog 1 (DLK1) is a growth factor that is reduced in maternal sera in pregnancies with small for gestational age neonates. We sought to determine if DLK1 is associated with stillbirth (SB), with and without placental insufficiency.<\/jats:p><jats:p>\n            Study Design\u2003A nested case-control study was performed using maternal sera from a multicenter case-control study of SB and live birth (LB). SB and LB were stratified as placental insufficiency cases (small for gestational age &lt;5% or circulatory lesions on placental histopathology) or normal placenta controls (appropriate for gestational age and no circulatory lesions). Enzyme-linked immunosorbent assay (ELISA) was used to measure DLK1. The mean difference in DLK1 was compared on the log scale in an adjusted linear regression model with pairwise differences, stratified by term\/preterm deliveries among DLK1 results in the quantifiable range. In exploratory analysis, geometric means were compared among all data and the proportion of \u201clow DLK1\u201d (less than the median value for gestational age) was compared between groups and modeled using linear and logistic regression, respectively.<\/jats:p><jats:p>\n            Results\u2003Overall, 234 SB and 234 LB were analyzed; 246 DLK1 values were quantifiable within the standard curve. Pairwise comparisons of case and control DLK1 geometric means showed no significant differences between groups. In exploratory analysis of all data, adjusted analysis revealed a significant difference for the LB comparison only (SB: 71.9 vs. 99.1 pg\/mL, p\u2009=\u20090.097; LB: 37.6 vs. 98.1 pg\/mL, p\u2009=\u20090.005). In exploratory analysis of \u201clow DLK1,\u201d there was a significant difference between the odds ratio of having \u201clow DLK1\u201d between preterm cases and controls for both SB and LB. There were no significant differences in geometric means nor \u201clow DLK1\u201d between SB and LB.<\/jats:p><jats:p>\n            Conclusion\u2003In exploratory analysis, more placental insufficiency cases in preterm SB and LB had \u201clow DLK1.\u201d However, low DLK1 levels were not associated with SB.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1877-6191","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T22:36:47Z","timestamp":1655419007000},"page":"e221-e229","source":"Crossref","is-referenced-by-count":6,"special_numbering":"S","title":["DLK1: A Novel Biomarker of Placental Insufficiency in Stillbirth and Live Birth"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2570-4333","authenticated-orcid":false,"given":"Jessica M.","family":"Page","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah"},{"name":"Division of Maternal-Fetal Medicine, Intermountain Health Care, Murray, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda A.","family":"Allshouse","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica E.","family":"Gaffney","sequence":"additional","affiliation":[{"name":"Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria H. J.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Division of Reproductive and Developmental Sciences, Oregon National Primate Research Center Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Thorsten","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7431-3451","authenticated-orcid":false,"given":"Karen J.","family":"Gibbins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald J.","family":"Dudley","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Saade","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Stoll","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol J.","family":"Hogue","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radek","family":"Bukowski","sequence":"additional","affiliation":[{"name":"Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corette","family":"Parker","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Conway","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma M.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9455-3973","authenticated-orcid":false,"given":"Michael W.","family":"Varner","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah"},{"name":"Division of Maternal-Fetal Medicine, Intermountain Health Care, Murray, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio E.","family":"Frias","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Silver","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences, Salt Lake City, Utah"},{"name":"Division of Maternal-Fetal Medicine, Intermountain Health Care, Murray, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"issue":"08","key":"ref1","first-page":"1","article-title":"Fetal and perinatal mortality: United States, 2013","volume":"64","author":"M F MacDorman","year":"2015","journal-title":"Natl Vital Stat Rep"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/S0140-6736(15)01020-X","article-title":"Stillbirths: recall to action in high-income countries","volume":"387","author":"V Flenady","year":"2016","journal-title":"Lancet"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.siny.2017.02.010","article-title":"Interventions to prevent stillbirth","volume":"22","author":"J M Page","year":"2017","journal-title":"Semin Fetal Neonatal 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