{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:25:26Z","timestamp":1787509526744,"version":"build-2736575974"},"reference-count":52,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Fetal growth abnormalities increase the risk of negative perinatal and long-term outcomes. Bisphenol A (BPA) is a ubiquitous endocrine-disrupting chemical to which humans may be exposed in a number of ways, such as from the environment, via various consumer products, and through the individual\u2019s diet. Since the compound possesses estrogen-mimicking properties and exerts epigenetic and genotoxic effects, it has been associated with harmful effects impacting the entire spectrum of human life, including, vitally, the intrauterine period. We investigated the role of maternal exposure to BPA in abnormal fetal growth velocity, both impaired and excessive. Materials and Methods: Amniotic fluid samples were collected from 35 women who underwent amniocentesis early in the second trimester due to medical reasons. Pregnancies were followed until delivery, and birth weights were recorded. The amniotic fluid samples were subsequently divided into three groups based on fetal birth weight, as follows: AGA (appropriate for gestational age), SGA (small for gestational age), and LGA (large for gestational age). Amniotic fluid BPA levels were determined by gas chromatography coupled with mass spectrometry. Results: BPA was detected in 80% (28\/35) of our amniotic fluid samples. Median concentration was 281.495 pg\/mL and ranged from 108.82 pg\/mL to 1605.36 pg\/mL. No significant association was observed between the study groups regarding BPA concentration. A significant positive correlation between amniotic fluid BPA concentration and birth weight centile (r = 0.351, p-value = 0.039) was identified. BPA levels were also inversely associated with gestational age in pregnancies at term (between 37 and 41 weeks) (r = \u22120.365, p-value = 0.031). Conclusions: Our findings suggest that maternal exposure to BPA during the early second trimester of pregnancy can potentially contribute to increased birthweight percentiles and to decreased gestational age in pregnancies at term.<\/jats:p>","DOI":"10.3390\/medicina59050882","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T03:24:32Z","timestamp":1683257072000},"page":"882","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Prenatal Exposure to Bisphenol A: Is There an Association between Bisphenol A in Second Trimester Amniotic Fluid and Fetal Growth?"],"prefix":"10.3390","volume":"59","author":[{"given":"Nikolaos","family":"Loukas","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tzaneio General Hospital, 185 36 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionysios","family":"Vrachnis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1333-4267","authenticated-orcid":false,"given":"Nikolaos","family":"Antonakopoulos","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-1633","authenticated-orcid":false,"given":"Vasilios","family":"Pergialiotis","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areti","family":"Mina","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Papoutsis","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Iavazzo","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Metaxa Memorial Cancer Hospital, 185 37 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2428-3992","authenticated-orcid":false,"given":"Alexandros","family":"Fotiou","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofoklis","family":"Stavros","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Valsamakis","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology, Endocrine Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Vlachadis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Kalamata General Hospital, 241 00 Kalamata, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Maroudias","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Tzaneio General Hospital, 185 36 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1929-3275","authenticated-orcid":false,"given":"George","family":"Mastorakos","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynecology, Endocrine Unit, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4316-7305","authenticated-orcid":false,"given":"Zoi","family":"Iliodromiti","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Drakakis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9067-5308","authenticated-orcid":false,"given":"Nikolaos","family":"Vrachnis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/0037-198X(90)90062-9","article-title":"Fetal growth disturbances","volume":"25","author":"Doubilet","year":"1990","journal-title":"Semin. Roentgenol."},{"key":"ref_2","unstructured":"Royal College of Obstetricians and Gynaecologists (2022, August 07). Small-for-Gestational-Age Fetus, Investigation and Management (Green-Top Guideline No. 31). Available online: https:\/\/www.rcog.org.uk\/media\/t3lmjhnl\/gtg_31.pdf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"8476217","DOI":"10.1155\/2018\/8476217","article-title":"Association between Brain-Derived Neurotrophic Factor (BDNF) Levels in 2nd Trimester Amniotic Fluid and Fetal Development","volume":"2018","author":"Antonakopoulos","year":"2018","journal-title":"Mediat. Inflamm."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"574857","DOI":"10.3389\/fped.2020.574857","article-title":"Overgrowth Syndromes-Evaluation, Diagnosis, and Management","volume":"8","author":"Manor","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1258\/shorts.2012.012048","article-title":"The fetal origins of adult disease: A narrative review of the epidemiological literature","volume":"3","author":"Skogen","year":"2012","journal-title":"JRSM Short Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1196\/annals.1365.028","article-title":"The Fetus That Is Small for Gestational Age","volume":"1092","author":"Vrachnis","year":"2006","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_7","first-page":"647","article-title":"Birthweight and mortality in adulthood: A systematic review and meta-analysis","volume":"40","author":"Risnes","year":"2011","journal-title":"Leuk. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1067\/mob.2003.302","article-title":"Macrosomic births in the united states: Determinants, outcomes, and proposed grades of risk","volume":"188","author":"Boulet","year":"2003","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"106904","DOI":"10.1016\/j.envint.2021.106904","article-title":"Identification of known and novel nonpolar endocrine disruptors in human amniotic fluid","volume":"158","author":"Dusza","year":"2022","journal-title":"Environ. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.jsbmb.2011.08.007","article-title":"Endocrine disrupting chemicals and disease susceptibility","volume":"127","author":"Schug","year":"2011","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4985","DOI":"10.1080\/14767058.2021.1873943","article-title":"Phthalates and fetal growth velocity: Tracking down the suspected links","volume":"35","author":"Vrachnis","year":"2021","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.etap.2014.02.003","article-title":"Bisphenol A\u2014Sources, toxicity and biotransformation","volume":"37","year":"2014","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jsbmb.2011.05.002","article-title":"Bisphenol A: An endocrine disruptor with widespread exposure and multiple effects","volume":"127","author":"Rubin","year":"2011","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1210\/en.2013-1370","article-title":"Bisphenol A: A Model Endocrine Disrupting Chemical With a New Potential Mechanism of Action","volume":"154","author":"Nagel","year":"2013","journal-title":"Endocrinology"},{"key":"ref_15","first-page":"19","article-title":"The Genotoxic and Cytotoxic Effects of Bisphenol-A (BPA) in MCF-7 Cell Line and Amniocytes","volume":"5","author":"Zabihi","year":"2016","journal-title":"Int. J. Mol. Cell Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"dvy022","DOI":"10.1093\/eep\/dvy022","article-title":"Impacts of bisphenol A (BPA) and phthalate exposures on epigenetic outcomes in the human placenta","volume":"4","author":"Strakovsky","year":"2018","journal-title":"Environ. Epigenetics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.reprotox.2013.08.008","article-title":"Bisphenol A and human health: A review of the literature","volume":"42","author":"Rochester","year":"2013","journal-title":"Reprod. Toxicol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Vrachnis, N., Loukas, N., Vrachnis, D., Antonakopoulos, N., Zygouris, D., K\u03bflialexi, A., Pergaliotis, V., Iavazzo, C., Mastorakos, G., and Iliodromiti, Z. (2021). A Systematic Review of Bisphenol A from Dietary and Non-Dietary Sources during Pregnancy and Its Possible Connection with Fetal Growth Restriction: Investigating Its Potential Effects and the Window of Fetal Vulnerability. Nutrients, 13.","DOI":"10.3390\/nu13072426"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.reprotox.2005.07.007","article-title":"Xenobiotic phenols in early pregnancy amniotic fluid","volume":"21","author":"Engel","year":"2006","journal-title":"Reprod. Toxicol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.reprotox.2012.03.009","article-title":"Fetal bisphenol A exposure: Concentration of conjugated and unconjugated bisphenol A in amniotic fluid in the second and third trimesters","volume":"34","author":"Edlow","year":"2012","journal-title":"Reprod. Toxicol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Vrachnis, N., Argyridis, S., Vrachnis, D., Antonakopoulos, N., Valsamakis, G., Iavazzo, C., Zygouris, D., Salakos, N., Rodolakis, A., and Vlahos, N. (2021). Increased Fibroblast Growth Factor 21 (FGF21) Concentration in Early Second Trimester Amniotic Fluid and Its Association with Fetal Growth. Metabolites, 11.","DOI":"10.3390\/metabo11090581"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1038\/44517","article-title":"Exposure to bisphenol A advances puberty","volume":"401","author":"Howdeshell","year":"1999","journal-title":"Nature"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1006\/bbrc.2002.6407","article-title":"Serum Bisphenol A Concentrations Showed Gender Differences, Possibly Linked to Androgen Levels","volume":"291","author":"Takeuchi","year":"2002","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.reprotox.2016.11.007","article-title":"Second trimester amniotic fluid bisphenol A concentration is associated with decreased birth weight in term infants","volume":"67","author":"Pinney","year":"2017","journal-title":"Reprod. Toxicol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1515\/jpm-2019-0040","article-title":"Simultaneous analysis of bisphenol A fractions in maternal and fetal compartments in early second trimester of pregnancy","volume":"47","author":"Miltyk","year":"2019","journal-title":"J. Perinat. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.ijheh.2013.07.005","article-title":"Prenatal bisphenol A and birth outcomes: MOCEH (Mothers and Children\u2019s Environmental Health) study","volume":"217","author":"Lee","year":"2014","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/j.scitotenv.2017.08.317","article-title":"Prenatal Bisphenol-A exposure affects fetal length growth by maternal glutathione transferase polymorphisms, and neonatal exposure affects child volume growth by sex: From multiregional prospective birth cohort MOCEH study","volume":"612","author":"Lee","year":"2018","journal-title":"Sci. Total Environ."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"125805","DOI":"10.1016\/j.chemosphere.2019.125805","article-title":"Prenatal exposure to bisphenol a and its analogues (bisphenol F and S) and ultrasound parameters of fetal growth","volume":"246","author":"Zhou","year":"2020","journal-title":"Chemosphere"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"106305","DOI":"10.1016\/j.envint.2020.106305","article-title":"Sex-specific associations of prenatal exposure to bisphenol A and its alternatives with fetal growth parameters and gestational age","volume":"146","author":"Yang","year":"2021","journal-title":"Environ. Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.reprotox.2008.05.058","article-title":"Maternal and fetal exposure to bisphenol A in Korea","volume":"25","author":"Lee","year":"2008","journal-title":"Reprod. Toxicol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.reprotox.2019.07.008","article-title":"A pilot study: Bisphenol\u2013A and Bisphenol-A glucuronide levels in mother and child pairs in a South African population","volume":"89","author":"Gounden","year":"2019","journal-title":"Reprod. Toxicol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1016\/j.scitotenv.2017.07.084","article-title":"Prenatal low-level phenol exposures and birth outcomes in China","volume":"607\u2013608","author":"Ding","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e17672","DOI":"10.1097\/MD.0000000000017672","article-title":"Association between prenatal exposure to bisphenol a and birth outcomes: A systematic review with meta-analysis","volume":"98","author":"Zhou","year":"2019","journal-title":"Medicine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/1476-069X-10-94","article-title":"Biomonitoring of bisphenol A concentrations in maternal and umbilical cord blood in regard to birth outcomes and adipokine expression: A birth cohort study in Taiwan","volume":"10","author":"Chou","year":"2011","journal-title":"Environ. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1016\/j.placenta.2014.08.091","article-title":"Placental concentrations of bisphenol A and birth weight from births in the Southeastern U.S","volume":"35","author":"Troisi","year":"2014","journal-title":"Placenta"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"112400","DOI":"10.1016\/j.ecoenv.2021.112400","article-title":"Association of BPA exposure during pregnancy with risk of preterm birth and changes in gestational age: A meta-analysis and systematic review","volume":"220","author":"Namat","year":"2021","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1021\/tx025548t","article-title":"Metabolism and Kinetics of Bisphenol A in Humans at Low Doses Following Oral Administration","volume":"15","author":"Colnot","year":"2002","journal-title":"Chem. Res. Toxicol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1289\/ehp.1104139","article-title":"Variability of Urinary Phthalate Metabolite and Bisphenol A Concentrations before and during Pregnancy","volume":"120","author":"Braun","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"128307","DOI":"10.1016\/j.chemosphere.2020.128307","article-title":"Independent and combined effects of Bisphenol A and Diethylhexyl Phthalate on gestational outcomes and offspring development in Sprague-Dawley rats","volume":"263","author":"Dagher","year":"2021","journal-title":"Chemosphere"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/fcp.12300","article-title":"Is bisphenol A an environmental obesogen?","volume":"31","author":"Legeay","year":"2017","journal-title":"Fundam. Clin. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1007\/s12020-016-1158-4","article-title":"The influence of phthalates and bisphenol A on the obesity development and glucose metabolism disorders","volume":"55","author":"Stojanoska","year":"2017","journal-title":"Endocrine"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"538474","DOI":"10.1155\/2012\/538474","article-title":"Impact of Maternal Diabetes on Epigenetic Modifications Leading to Diseases in the Offspring","volume":"2012","author":"Vrachnis","year":"2012","journal-title":"Exp. Diabetes Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1158\/1055-9965.EPI-06-0158","article-title":"Estrogen and \u03b1-Fetoprotein Levels in Maternal and Umbilical Cord Blood Samples in Relation to Birth Weight","volume":"15","author":"Nagata","year":"2006","journal-title":"Cancer Epidemiology Biomarkers Prev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.chemosphere.2014.03.042","article-title":"Bisphenol A is related to circulating levels of adiponectin, leptin and ghrelin, but not to fat mass or fat distribution in humans","volume":"112","author":"Lind","year":"2014","journal-title":"Chemosphere"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1038\/s41598-017-00941-y","article-title":"Maternal lipids and leptin concentrations are associated with large-for-gestational-age births: A prospective cohort study","volume":"7","author":"Farias","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S1875-9572(09)60073-5","article-title":"Association of Cord Plasma Leptin With Birth Size in Term Newborns","volume":"50","author":"Tung","year":"2009","journal-title":"Pediatr. Neonatol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Benincasa, L., Mandal\u00e0, M., Paulesu, L., Barberio, L., and Ietta, F. (2020). Prenatal Nutrition Containing Bisphenol A Affects Placenta Glucose Transfer: Evidence in Rats and Human Trophoblast. Nutrients, 12.","DOI":"10.3390\/nu12051375"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Barberio, L., Paulesu, L., Canesi, L., Grasselli, E., and Mandal\u00e0, M. (2021). Bisphenol a Interferes with Uterine Artery Features and Impairs Rat Feto-Placental Growth. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22136912"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Vidal, M.S., Menon, R., Yu, G.F.B., and Amosco, M.D. (2022). Actions of Bisphenol A on Different Feto-Maternal Compartments Contributing to Preterm Birth. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23052411"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1038\/sj.jp.7211290","article-title":"Amniotic Fluid: Not Just Fetal Urine Anymore","volume":"25","author":"Underwood","year":"2005","journal-title":"J. Perinatol."},{"key":"ref_51","first-page":"799","article-title":"Impact of mediators present in amniotic fluid on preterm labour","volume":"26","author":"Vrachnis","year":"2012","journal-title":"In Vivo"},{"key":"ref_52","first-page":"327","article-title":"Association of adiponectin and placental growth factor in amniotic fluid with second trimester fetal growth","volume":"26","author":"Kalampokas","year":"2012","journal-title":"In Vivo"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/5\/882\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:29:07Z","timestamp":1760124547000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/5\/882"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,4]]},"references-count":52,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["medicina59050882"],"URL":"https:\/\/doi.org\/10.3390\/medicina59050882","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,4]]}}}