{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:00:21Z","timestamp":1788789621611,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":4,"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":[[2022,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of a first\u2010trimester combined screening program for pre\u2010eclampsia, based on the Fetal Medicine Foundation (FMF) algorithm, on the rate of small\u2010for\u2010gestational age (SGA) at birth and adverse pregnancy outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of data obtained from a London tertiary hospital between January 2017 and March 2019. The data were derived from a secondary analysis of the cohort evaluated in a clinical\u2010effectiveness study on the implementation of a first\u2010trimester screening program for pre\u2010eclampsia. The cohort included 7720 women screened according to the UK National Institute for Health and Care Excellence (NICE) risk\u2010based approach and 4841 women screened by the FMF multimodal approach, which combines maternal risk factors, blood pressure, pregnancy\u2010associated plasma protein\u2010A and uterine artery Doppler indices. The care package for the FMF\u2010screened group included 150\u2010mg aspirin prophylaxis, ultrasound scans at 28 and 36\u2009weeks' gestation and scheduled delivery at 40\u2009weeks. Outcome measures included the rates of SGA neonates at birth, admission to the neonatal unit, intrauterine demise, neonatal death and hypoxic\u2013ischemic encephalopathy assessed by interrupted time series analysis (ITSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no significant difference in the rates of intrauterine demise, neonatal death and hypoxic\u2013ischemic encephalopathy between the FMF\u2010screened and NICE\u2010screened cohorts. ITSA showed a significant reduction in the rate of term SGA birth &lt;\u200910<jats:sup>th<\/jats:sup> percentile at 21\u2009months following implementation of the FMF screening program, with a relative effect reduction of 45.1% (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). However, there was no significant relative effect reduction in term SGA birth &lt;\u20095<jats:sup>th<\/jats:sup> or &lt;\u20093<jats:sup>rd<\/jats:sup> percentile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>First\u2010trimester combined screening for pre\u2010eclampsia based on the FMF algorithm accompanied by a care package including serial ultrasound scans for growth evaluation and elective birth from 40\u2009weeks' gestation resulted in a significant 45% relative effect reduction in term SGA birth &lt;\u200910<jats:sup>th<\/jats:sup> percentile but did not affect term SGA birth &lt;\u20095<jats:sup>th<\/jats:sup> or &lt;\u20093<jats:sup>rd<\/jats:sup> percentile. Further screening strategies to detect and improve the outcome of cases with SGA birth &lt;\u20095<jats:sup>th<\/jats:sup> percentile need to be considered. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23741","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T15:15:54Z","timestamp":1627485354000},"page":"55-60","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Effect of routine first\u2010trimester combined screening for\u00a0pre\u2010eclampsia on small\u2010for\u2010gestational\u2010age birth: secondary interrupted time series analysis"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8198-9698","authenticated-orcid":false,"given":"G. P.","family":"Guy","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Leslie","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Department of Obstetrics and Gynaecology Ashford and St Peter's NHS Foundation Trust, Lyne  Chertsey UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Diaz Gomez","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Forenc","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Buck","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2393-7501","authenticated-orcid":false,"given":"A.","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"},{"name":"Tommy's National Centre for Maternity Improvement Royal College of Obstetricians and Gynaecologists  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19039"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16361"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19081"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23523"},{"issue":"580","key":"e_1_2_7_7_1","first-page":"e1","article-title":"Aspirin delays the development of preeclampsia","volume":"220","author":"Wright D","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11112"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13229"},{"key":"e_1_2_7_10_1","unstructured":"Effective Practice and Organisation of Care (EPOC)2020.Interrupted Time Series Analysis Guide. 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