{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T10:16:02Z","timestamp":1769595362879,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"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; Gyne"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To develop a continuous likelihood model for pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A), in the context of a new competing\u2010risks model for prediction of a small\u2010for\u2010gestational\u2010age (SGA) neonate, and to compare the predictive performance of the new model for SGA to that of previous methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study of 60\u2009875 women with singleton pregnancy undergoing routine ultrasound examination at 11\u2009+\u20090 to 13\u2009+\u20096\u2009weeks' gestation. The dataset was divided randomly into a training dataset and a test dataset. The training dataset was used for PAPP\u2010A likelihood model development. We used Bayes' theorem to combine the previously developed prior model for the joint Gaussian distribution of gestational age (GA) at delivery and birth\u2010weight <jats:italic>Z<\/jats:italic>\u2010score with the PAPP\u2010A likelihood to obtain a posterior distribution. This patient\u2010specific posterior joint Gaussian distribution of GA at delivery and birth\u2010weight <jats:italic>Z<\/jats:italic>\u2010score allows risk calculation for SGA defined in terms of different birth\u2010weight percentiles and GA. The new model was validated internally in the test dataset and we compared its predictive performance to that of the risk\u2010scoring system of the UK National Institute for Health and Care Excellence (NICE) and that of logistic regression models for different SGA definitions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PAPP\u2010A has a continuous association with both birth\u2010weight <jats:italic>Z<\/jats:italic>\u2010score and GA at delivery according to a folded\u2010plane regression. The new model, with the addition of PAPP\u2010A, was equal or superior to several logistic regression models. The new model performed well in terms of risk calibration and consistency across different GAs and birth\u2010weight percentiles. In the test dataset, at a false\u2010positive rate of about 30% using the criteria defined by NICE, the new model predicted 62.7%, 66.5%, 68.1% and 75.3% of cases of a SGA neonate with birth weight &lt;\u200910<jats:sup>th<\/jats:sup> percentile delivered at &lt;\u200942, &lt;\u200937, &lt;\u200934 and &lt;\u200930\u2009weeks' gestation, respectively, which were significantly higher than the respective values of 46.7%, 55.0%, 55.9% and 52.8% achieved by application of the NICE guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using Bayes' theorem to combine PAPP\u2010A measurement data with maternal characteristics improves the prediction of SGA and performs better than logistic regression or NICE guidelines, in the context of a new competing\u2010risks model for the joint distribution of birth\u2010weight <jats:italic>Z<\/jats:italic>\u2010score and GA at delivery. \u00a9 2020 International Society of Ultrasound in Obstetrics and Gynecology<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.22175","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T15:29:20Z","timestamp":1596900560000},"page":"541-548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Competing\u2010risks\u2009model\u2009for\u2009prediction\u2009of\u2009small\u2010for\u2010gestational\u2010age neonate from maternal characteristics and serum pregnancy\u2010associated plasma <scp>protein\u2010A<\/scp> at 11\u201313\u2009weeks' gestation"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-1435","authenticated-orcid":false,"given":"I.","family":"Papastefanou","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Wright","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Exeter  Exeter UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Lolos","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Anampousi","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. H.","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.06.039"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.030"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.233"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182a265ab"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200606000-00009"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.004"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.01.227"},{"key":"e_1_2_7_9_1","volume-title":"RCOG","author":"Royal College of Obstetricians and Gynaecologists","year":"2014"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2520"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000321694"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01271.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15919"},{"issue":"62","key":"e_1_2_7_14_1","first-page":"e1","article-title":"Competing\u2009risks model in screening for preeclampsia by maternal characteristics and medical history","volume":"213","author":"Wright D","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.08.034"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.11.1087"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22129"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2637"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1975.tb00710.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2307\/2348941"},{"key":"e_1_2_7_23_1","volume-title":"R: a language and environment for statistical computing","author":"R Development Core Team"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.22175","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.22175","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.22175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T09:19:58Z","timestamp":1693732798000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.22175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1002\/uog.22175"],"URL":"https:\/\/doi.org\/10.1002\/uog.22175","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"2020-06-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}