{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:57:22Z","timestamp":1788872242245,"version":"build-2803163510"},"reference-count":98,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delayed villous maturation (DVM) is a placental maturation disorder that mainly affects maternal\u2010to\u2010foetal oxygen transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review, meta\u2010analysis, and sensitivity analysis exploring study heterogeneities (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      ) of risk factors and outcomes associated with histopathological findings of DVM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>Medline, EMBASE, Web of Science, and MIDIRS databases were searched from inception to December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Peer\u2010reviewed, observational studies including cohort, case\u2013control, and cross\u2010sectional studies reported the histopathological findings of DVM after placenta delivery. All eligible studies were included and assessed for their risk of bias using the Newcastle\u2010Ottawa scale (NOS) for cohort and case\u2013control studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>Two reviewers independently performed the systematic article screening, bias assessment, and data extraction. Senior authors resolved the disagreement between reviewers. The risk of bias was assessed by two reviewers using NOS criteria. The random\u2010effects model was used for meta\u2010analysis due to heterogeneity across studies. Sensitivity analyses were performed according to the NOS risk of bias assessment and the DVM definition per the Amsterdam criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two eligible studies reporting DVM and linked risk factors and outcomes were included. The risk factors associated with DVM were gestational diabetes (GDM) (OR\u2009=\u20094.90; 95% CI\u2009=\u20092.98, 8.06;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200939%), pregestational diabetes (PGDM) (OR\u2009=\u20092.77; 95% CI\u2009=\u20091.56, 4.92;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), and maternal obesity (OR\u2009=\u20091.88; 95% CI\u2009=\u20091.20, 2.96;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). DVM was also associated with congenital foetal malformations (OR\u2009=\u20095.22; 95% CI =2.39, 11.39;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      \u2009=\u200940), stillbirth (OR\u2009=\u20094.89; 95% CI\u2009=\u20093.55, 6.72;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>\n                        <jats:italic>2<\/jats:italic>\n                      <\/jats:sup>\n                      \u2009=\u20090) and preterm birth (OR\u2009=\u200917.41; 95% CI\u2009=\u200910.14, 29.90;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090). The association between DVM and stillbirth (OR\u2009=\u200912.06; 95% CI =3.40, 42.78;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200950; 2\/5 studies) persisted in analyses limited to studies that used Amsterdam criteria exclusively for DVM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DVM is a placental abnormality associated with congenital foetal malformations and maternal dysmetabolism, including GDM, PGDM, and maternal obesity; and with adverse outcomes including stillbirth and preterm birth. In studies using Amsterdam criteria, placenta with DVM was associated with stillbirth and congenital malformations. Optimising metabolism could prevent harm to the baby.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70125","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T08:23:01Z","timestamp":1768292581000},"page":"900-921","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Risk Factors and Outcomes Associated With Delayed Villous Maturation in Placenta: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7521-9221","authenticated-orcid":false,"given":"Muhammad Pradhiki","family":"Mahindra","sequence":"first","affiliation":[{"name":"Maternal\u2010Fetal Medicine Department University College London Elizabeth Garrett Anderson Institute for Women's Health  London UK"},{"name":"Harapan Kita National Women and Children Centre  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Pradhika","family":"Mapindra","sequence":"additional","affiliation":[{"name":"Harapan Kita National Women and Children Centre  Jakarta Indonesia"},{"name":"Neonatology Department University College London Elizabeth Garrett Anderson Institute for Women's Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadi","family":"Waheed","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Department University College London Elizabeth Garrett Anderson Institute for Women's Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Department University College London Elizabeth Garrett Anderson Institute for Women's Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Ciaran","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Perinatal Pathology Great Ormond Street Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L.","family":"Hillman","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Department University College London Elizabeth Garrett Anderson Institute for Women's Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1078-9856","authenticated-orcid":false,"given":"Dimitrios","family":"Siassakos","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Department University College London Elizabeth Garrett Anderson Institute for Women's Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2004.03.006"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2020-0014"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpdhp.2012.02.002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0225-CC"},{"key":"e_1_2_11_6_1","first-page":"1096","volume-title":"Histology for Pathologists","author":"Benirschke K.","year":"2012"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2350\/06\u201001\u20100015.1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02133969"},{"key":"e_1_2_11_9_1","first-page":"92","article-title":"Placenta Examination and Pathology","volume":"27","author":"Nagi A. 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