{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:20Z","timestamp":1787013860436,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Umbilical venous blood flow (UV\u2010Q) reflects fetoplacental circulation and contributes to an understanding of fetal physiology. It may also serve as a basis for developing new diagnostic tools to assess fetal wellbeing. This study aimed to investigate UV\u2010Q patterns in pregnancies complicated by gestational diabetes mellitus (GDM) and to examine the associations between absolute and fetal weight\u2010normalized UV\u2010Q and placental size and histologic features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>This prospective study was conducted at a university hospital in Bangkok, Thailand, between December 2021 and May 2024. A total of 200 singleton pregnancies complicated by GDM underwent ultrasound assessment between 35 and 36\u2009weeks of gestation. Measurements included estimated fetal weight, umbilical vein diameter, and Doppler\u2010derived flow velocity. Absolute and normalized UV\u2010Q values were calculated and categorized into three groups: &lt;10th, 10th\u201390th (reference), and &gt;90th percentiles. After delivery, placental morphometry (weight, diameter, circumference, and volume) and histologic features\u2014including maternal and fetal vascular malperfusion, delayed villous maturation (DVM), and chorangiosis\u2014were evaluated. Associations between UV\u2010Q and placental size were assessed using one\u2010way analysis of covariance, adjusting for parity, insulin use, gestational age at delivery, birthweight, and infant sex. These covariates were also included in the multivariable logistic regression models to examine associations between UV\u2010Q and histologic findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher absolute UV\u2010Q was significantly associated with greater placental weight, diameter, circumference, and volume (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018\u20130.049). Additionally, in multivariable analysis, pregnancies with absolute UV\u2010Q &gt;90th percentile had a significantly increased risk of DVM (adjusted odds ratio 2.75, 95% confidence interval 1.02\u20137.86). In contrast, normalized UV\u2010Q showed no significant associations with placental morphometric features or DVM. Furthermore, neither absolute nor normalized UV\u2010Q was significantly associated with other histologic placental abnormalities, including maternal or fetal vascular malperfusion or chorangiosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In pregnancies complicated by GDM, elevated absolute UV\u2010Q was associated with increased placental size and a higher risk of DVM. These findings suggest that absolute UV\u2010Q may serve as a noninvasive indicator of placental structural adaptation and function in diabetic pregnancies. Further research is needed to clarify the clinical significance and underlying mechanisms of these associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70073","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T19:31:32Z","timestamp":1760556692000},"page":"2244-2253","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Umbilical venous blood flow and its association with placental pathology in pregnancies complicated by gestational diabetes mellitus"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0925-2613","authenticated-orcid":false,"given":"Chadakarn","family":"Phaloprakarn","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital Navamindradhiraj University  Bangkok 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