{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:57:30Z","timestamp":1791406650617,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although systemic lupus erythematosus (SLE) pregnancy frequently results in small for gestational age (SGA) infants, the understanding of underlying mechanisms is limited. We aimed to identify specific histological patterns of placental injury in SGA in SLE and to explore whether an altered balance of angiogenesis\u2010related proteins precedes this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively followed 83 SLE and 67 control pregnancies. Placental histological patterns were determined according to the Amsterdam consensus in 63 women with SLE (76%), of whom 10 developed SGA. Soluble fms\u2010like tyrosine kinase 1 (sFlt\u20101) and placental growth factor (PlGF) in plasma were quantified using LEGENDplex in the first, second and third trimesters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SLE patients remain at risk of having an SGA infant, and their placentas and infants had lower weight compared to controls. In placentas from women with SLE and SGA, maternal vascular malperfusion lesions were common (80% vs. 30% in controls;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.010), but inflammatory lesions were not observed. Women with maternal vascular malperfusion gave birth to infants with lower birth weight compared to women without these lesions. The ratio of sFlt\u20101:PlGF in the third trimester was elevated in women with SLE with an SGA infant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a prospective cohort of well\u2010controlled SLE patients with low disease activity delivering mostly at term, SGA and small placentas remain common. The increased prevalence of placental malperfusion lesions together with an altered balance of pro\u2010 and anti\u2010angiogenic proteins suggests that the role of vascular and angiogenesis\u2010related factors should be further explored in relation to SGA in SLE pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.70140","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:48:01Z","timestamp":1784803681000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Placental malperfusion and angiogenesis\u2010related proteins are associated with small\u2010for\u2010gestational\u2010age in systemic lupus erythematosus"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4438-4849","authenticated-orcid":false,"given":"Marit","family":"Stockfelt","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Inflammation Research Institute of Medicine Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"},{"name":"Rheumatology, Sahlgrenska University Hospital Western Healthcare Region  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8059-8457","authenticated-orcid":false,"given":"Henri","family":"Puttonen","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Helsinki  Helsinki Finland"},{"name":"Department of Pathology HUS Diagnostic Center Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ing\u2010Marie","family":"Fyhr","sequence":"additional","affiliation":[{"name":"Department of Pathology Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5063-092X","authenticated-orcid":false,"given":"Agnes","family":"Torell","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research Institute of Medicine Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research Institute of Medicine Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4514-7706","authenticated-orcid":false,"given":"Iva","family":"Gunnarsson","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna Division of Rheumatology Karolinska Institute Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3396-3244","authenticated-orcid":false,"given":"Elisabet","family":"Svenungsson","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna Division of Rheumatology Karolinska Institute Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9843-3127","authenticated-orcid":false,"given":"Agneta","family":"Zickert","sequence":"additional","affiliation":[{"name":"Department of Medicine Solna Division of Rheumatology Karolinska Institute Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6532-022X","authenticated-orcid":false,"given":"Maria Majczuk","family":"Sennstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women's and Childrens Health, Division for Obstetrics, Gynecology and Neonatology, Karolinska Institute Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Trysberg","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research Institute of Medicine Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders A.","family":"Bengtsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Rheumatology Lund University Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4418-5786","authenticated-orcid":false,"given":"Andreas","family":"J\u00f6nsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Rheumatology Lund University Sk\u00e5ne University Hospital  Lund 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