{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:05:20Z","timestamp":1785114320864,"version":"3.55.0"},"reference-count":26,"publisher":"Societatea Romana de Morfologie","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rom J Morphol Embryol"],"published-print":{"date-parts":[[2025,8,27]]},"abstract":"<jats:p>Background: Maternal dysmetabolism and low-grade inflammation accelerate fetal aortic wall thickening. Whether concomitant placental vascular or inflammatory lesions amplify this risk is unknown. Participants, Materials and Methods: 88 women with singleton, anatomically normal pregnancies were phenotyped at 24\u201326 weeks (visit 1, V1) and 32\u201334 weeks (visit 2, V2). Dynamic maternal markers [(\u0394 triglyceride\u2013glucose (TyG) index, \u0394 interleukin-6 (IL-6), \u0394 high-sensitivity C-reactive protein (hsCRP), \u0394 flow-mediated dilation (FMD)] again generated three metabolic inflammatory response phenotypes (MIRP-1\/-2\/-3). Placentas were examined by pathologists. A placental malperfusion\u2013inflammation composite (PMIC) score (0\u201310) summed semiquantitative grades of maternal vascular malperfusion (MVM), distal villous immaturity, chronic villitis of unknown etiology (CVUE) and acute chorioamnionitis. Results: Adequate placental tissue was obtained from 84 (95%) dyads. Median PMIC rose step wise from MIRP-1 = 2 [interquartile range (IQR) 1\u20133] to MIRP-2 = 5 [IQR 3\u20136] and MIRP-3 = 7 [IQR 6\u20139] (p 0.001). In mixed effects modelling, PMIC independently predicted fetal abdominal aorta intima\u2013media thickness (IMT) progression [\u03b2=+0.012 mm per PMIC point; 95% confidence interval (CI): 0.007\u20130.017; p 0.001] alongside \u0394 TyG and \u0394 IL-6 (R2 conditional = 0.61). Mothers in the high risk combined phenotype (MIRP-3 + PMIC \u22657; n=25) exhibited a mean IMT increment of +0.21\u00b10.05 mm vs. +0.06\u00b10.03 mm in the double low reference group (MIRP-1 + PMIC \u22643; n=22; p 0.001). A five variable XGBoost model [\u0394 TyG, \u0394 IL-6, \u0394 FMD, PMIC, baseline body mass index (BMI)] identified fetuses with late gestation high IMT (\u226590th percentile) with area under the receiver operating characteristic (AUROC) 0.91, outperforming the parent model lacking PMIC (AUROC 0.88). Conclusions: Placental vascular and inflammatory lesions potentiate the impact of adverse maternal metabolic inflammatory trajectories on fetal arterial remodeling. Integrating rapid placental histology with dynamic TyG inflammation endothelial indices could refine perinatal risk stratification and guide both ante and postpartum surveillance.<\/jats:p>","DOI":"10.47162\/rjme.66.2.09","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:31:18Z","timestamp":1756729878000},"page":"361-366","source":"Crossref","is-referenced-by-count":1,"title":["Dynamic TyG\u2013inflammation\u2013endothelial trajectories and placental histopathology synergistically define a maternal\u2013fetal vascular risk phenotype"],"prefix":"10.47162","volume":"66","author":[{"name":"Doctoral School, Victor Babe\u015f University of Medicine and Pharmacy, Timi\u015foara, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biliana Alexandra","family":"Belovan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Claudiu","family":"Ra\u0163iu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Obstetrics and Gynecology, Victor Babe\u015f University of Medicine and Pharmacy, Timi\u015foara, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioan","family":"Sas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Obstetrics and Gynecology, Victor Babe\u015f University of Medicine and Pharmacy, Timi\u015foara, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana Gabriela","family":"Stana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Discipline of Anatomy and Embryology, Department I, Victor Babe\u015f University of Medicine and Pharmacy, Timi\u015foara, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"26736","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"\"[1] Barker DJP. 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