{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:20:43Z","timestamp":1789842043899,"version":"4.0.1"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Skeletal dysplasia is usually apparent in the second trimester. First trimester femur\u2010length\/biparietal diameter (FL\/BPD), FL\/abdominal circumference (AC) and FL\/foot for the screening of skeletal dysplasia were evalauted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Case\u2010control study: pregnancies with molecular confirmation of skeletal dysplasia undergoing nuchal translucency (January_2007\u2013December_2021). Controls included pregnancies without fetal abnormalities. Performance of FL\/BPD, FL\/AC and FL\/foot was evaluated by receiver operating characteristic curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010eight skeletal dysplasia cases were identified; 17 (60.71%) corresponded to lethal types. Compared to 184 controls, cases had a lower median FL\/BPD (0.34 [IQR 0.30\u20130.38] vs. 0.44 [IQR 0.39\u20130.48]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), FL\/AC (0.13 [IQR 0.09\u20130.15] vs. 0.15 [IQR 0.13\u20130.16]; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and FL\/foot (0.84 [IQR 0.76\u20130.91] vs. 1.01 [IQR 0.94\u20131.11]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). FL\/BPD and FL\/foot ratios had a superior area under the curve (0.846 and 0.853, respectively) than FL\/AC (0.64). The probability of diagnosing skeletal dysplasia increased at least 9\u2010fold if FL\/BPD &lt;0.376 (OR 26.05, 95% CI 9.79\u201369.3; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and 14\u2010fold if FL\/foot &lt;0.891 (OR 39.46, 95% CI 14.17\u2013109.9; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Low FL\/BPD and FL\/foot were associated significantly with lethal types compared to viable skeletal dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>First trimester FL\/BPD and FL\/foot may be of clinical utility in the detection of skeletal dysplasia especially when there is another suspicious sonographic sign or when there is a relevant family history before overt second trimester sonographic markers become apparent.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.6295","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T04:53:01Z","timestamp":1672203181000},"page":"919-928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation of first trimester ultrasound fetal biometry ratios femur length\/biparietal diameter, femur length\/abdominal circumference and femur length\/foot for the screening of skeletal dysplasia"],"prefix":"10.1002","volume":"43","author":[{"given":"Ellen M.","family":"Murrin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Inova Health System  Falls Church Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Nelsen","sequence":"additional","affiliation":[{"name":"Women's Health of Central Virginia  Lynchburg Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Apostolakis\u2010Kyrus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Johns Hopkins All Children's Maternal, Fetal &amp; Neonatal Institute  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Hitchings","sequence":"additional","affiliation":[{"name":"Children's National Health System Prenatal Pediatric Institute  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Inova Health System  Falls Church Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8924-6386","authenticated-orcid":false,"given":"Luis M.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Inova Health System  Falls Church Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/gim.0b013e3181971ccb"},{"key":"e_1_2_9_3_1","first-page":"441","article-title":"Birth prevalence of skeletal dysplasias in the Italian Multicentric Monitoring System for Birth Defects","volume":"104","author":"Camera G","year":"1982","journal-title":"Prog Clin Biol Res"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.284075122"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.61366"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2015.03.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-198704000-00002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.34052"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2638"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.17219\/acem\/134166"},{"key":"e_1_2_9_11_1","first-page":"181","article-title":"The fetal femur\/foot length ratio: a new parameter to assess dysplastic limb reduction","volume":"72","author":"Campbell J","year":"1988","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2003.22.3.255"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2017.04.021"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2017.07.063"},{"key":"e_1_2_9_15_1","first-page":"627","article-title":"Receiver Operating Characteristic (ROC) curve analysis for medical diagnostic test evaluation","volume":"4","author":"Hajian\u2010Tilaki K","year":"2013","journal-title":"Caspian J Intern Med"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4028"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469\u20100705.1998.11060391.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2676"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469\u20100705.1994.04010034.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"}],"container-title":["Prenatal Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.6295","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pd.6295","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pd.6295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T12:13:48Z","timestamp":1692533628000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/pd.6295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,4]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/pd.6295"],"URL":"https:\/\/doi.org\/10.1002\/pd.6295","archive":["Portico"],"relation":{},"ISSN":["0197-3851","1097-0223"],"issn-type":[{"value":"0197-3851","type":"print"},{"value":"1097-0223","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,4]]},"assertion":[{"value":"2022-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}