{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:33:43Z","timestamp":1775738023198,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T00:00:00Z","timestamp":1422316800000},"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":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop an integrated model with the best performing criteria for predicting adverse outcome in small\u2010for\u2010gestational\u2010age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>) pregnancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 509 pregnancies with a suspected <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> fetus, eligible for trial of labor, was recruited prospectively and data on perinatal outcome were recorded. A predictive model for emergency Cesarean delivery because of non\u2010reassuring fetal status or neonatal acidosis was constructed using a decision tree analysis algorithm, with predictors: maternal age, body mass index, smoking, nulliparity, gestational age at delivery, onset of labor (induced <jats:italic>vs<\/jats:italic> spontaneous), estimated fetal weight (<jats:styled-content style=\"fixed-case\">EFW<\/jats:styled-content>), umbilical artery pulsatility index (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>), mean uterine artery (<jats:styled-content style=\"fixed-case\">UtA<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>, fetal middle cerebral artery <jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content> and cerebroplacental ratio (<jats:styled-content style=\"fixed-case\">CPR<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An adverse outcome occurred in 134 (26.3%) cases. The best performing predictors for defining a high risk for adverse outcome in <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> fetuses was the presence of a <jats:styled-content style=\"fixed-case\">CPR<\/jats:styled-content> &lt;\u200910<jats:sup>th<\/jats:sup> centile, a mean <jats:styled-content style=\"fixed-case\">UtA\u2010PI<\/jats:styled-content> &gt;\u200995<jats:sup>th<\/jats:sup> centile or an <jats:styled-content style=\"fixed-case\">EFW<\/jats:styled-content> &lt;\u20093<jats:sup>rd<\/jats:sup> centile. The algorithm showed a sensitivity, specificity and positive and negative predictive values for adverse outcome of 82.8% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 75.1\u201388.6%), 47.7% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 42.6\u201352.9%), 36.2% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 30.8\u201341.8%) and 88.6% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 83.2\u201392.5%), respectively. Positive and negative likelihood ratios were 1.58 and 0.36.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our model could be used as a diagnostic tool for discriminating <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> pregnancies at risk of adverse perinatal outcome. Copyright \u00a9 2014 ISUOG. 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