{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T04:38:17Z","timestamp":1769834297784,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,25]],"date-time":"2019-07-25T00:00:00Z","timestamp":1564012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100010983","name":"Health Research Fund of Central Denmark Region","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010983","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the relationship between small fetal second\u2010trimester head circumference (HC) and pregnancy outcome and identify a cutoff point for offering genetic testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data from second\u2010trimester scans in Denmark were linked to national registers. Fetuses with anomalies diagnosed before this scan were excluded. Fetuses were grouped according to HC z\u2010score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 352 515 singleton fetuses. The mean HC was significantly larger among males than among females with z\u2010scores averaging 0.52 more in males. Small HC was associated with chromosomal anomaly, malformations of the CNS and heart, miscarriage\/perinatal death, termination, preterm delivery, and intrauterine growth restriction (test for trend: <jats:italic>P<\/jats:italic> &lt; .001 for all outcomes). Fetuses in the group with z\u2010score less than \u20133 had the highest incidence of adverse outcome, irrespective of fetal sex. In the groups with z\u2010scores between \u20133 and \u20132.5, and between \u20132.5 and \u20132, risk of adverse outcome was lower for females than males for all outcome categories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Small HC in second trimester is a prognostic marker for adverse outcome. The smaller the HC, the higher the risk of adverse outcome. We suggest an HC cutoff point of \u20132 SD for males and \u20132.5 SD for females for offering genetic testing.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.5504","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T08:43:34Z","timestamp":1561020214000},"page":"910-920","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Second\u2010trimester fetal head circumference in more than 350 000 pregnancies: Outcome and suggestion for sex\u2010dependent cutoffs for small heads"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9444-3256","authenticated-orcid":false,"given":"Najaaraq","family":"Lund","sequence":"first","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Puk","family":"Sandager","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Katrine","family":"Leonhard","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ida","family":"Vogel","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Genetics Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olav Bj\u00f8rn","family":"Petersen","sequence":"additional","affiliation":[{"name":"Center for Fetal Diagnostics Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynecology Aarhus University Hospital  Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11694.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01678.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2006.01.010"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11111.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.810908.x"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11695.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1082"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00311.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6109"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318187d034"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-017-4380-2"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.452"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2017.03.014"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.3923"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200105000-00019"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12581"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15801"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5225"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1996.tb14164.x"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.13286"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)91342-6"},{"key":"e_1_2_10_23_1","unstructured":"GjerrisAC J\u00f8rgensenC BennedsenH et al.Biometriguideline.2008. 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