{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:44:50Z","timestamp":1790671490912,"version":"4.1.0"},"reference-count":38,"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"}],"funder":[{"DOI":"10.13039\/501100003123","name":"Fetal Medicine Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003123","id-type":"DOI","asserted-by":"publisher"}]}],"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 examine the performance of a model combining maternal risk factors, uterine artery pulsatility index (UtA\u2010PI) and estimated fetal weight (EFW) at 19\u201324\u2009weeks' gestation, for predicting all antepartum stillbirths and those due to impaired placentation, in a training dataset used for development of the model and in a validation dataset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data for this study were derived from prospective screening for adverse obstetric outcome in women with singleton pregnancy attending for routine pregnancy care at 19\u2009+\u20090 to 24\u2009+\u20096\u2009weeks' gestation. The study population was divided into a training dataset used to develop prediction models for placental dysfunction\u2010related antepartum stillbirth and a validation dataset to which the models were then applied. Multivariable logistic regression analysis was used to develop a model based on a combination of maternal risk factors, EFW <jats:italic>Z<\/jats:italic>\u2010score and UtA\u2010PI multiples of the normal median. We examined the predictive performance of the model by, first, the ability of the model to discriminate between the stillbirth and live\u2010birth groups, using the area under the receiver\u2010operating\u2010characteristics curve (AUC) and the detection rate (DR) at a fixed false\u2010positive rate (FPR) of 10%, and, second, calibration by measurements of calibration slope and intercept.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population of 131\u2009514 pregnancies included 131\u2009037 live births and 477 (0.36%) stillbirths. There are four main findings of this study. First, 92.5% (441\/477) of stillbirths were antepartum and 7.5% (36\/477) were intrapartum, and 59.2% (261\/441) of antepartum stillbirths were observed in association with placental dysfunction and 40.8% (180\/441) were unexplained or due to other causes. Second, placental dysfunction accounted for 80.1% (161\/201) of antepartum stillbirths at &lt;\u200932\u2009weeks' gestation, 54.2% (52\/96) at 32\u2009+\u20090 to 36\u2009+\u20096\u2009weeks and 33.3% (48\/144) at \u2265\u200937\u2009weeks. Third, the risk of placental dysfunction\u2010related antepartum stillbirth increased with increasing maternal weight and decreasing maternal height, was 3\u2010fold higher in black than in white women, was 5.5\u2010fold higher in parous women with previous stillbirth than in those with previous live birth, and was increased in smokers, in women with chronic hypertension and in parous women with a previous pregnancy complicated by pre\u2010eclampsia and\/or birth of a small\u2010for\u2010gestational\u2010age baby. Fourth, in screening for placental dysfunction\u2010related antepartum stillbirth by a combination of maternal risk factors, EFW and UtA\u2010PI in the validation dataset, the DR at a 10% FPR was 62.3% (95%\u2009CI, 57.2\u201367.4%) and the AUC was 0.838 (95%\u2009CI, 0.799\u20130.878); these results were consistent with those in the dataset used for developing the algorithm and demonstrate high discrimination between affected and unaffected pregnancies. Similarly, the calibration slope was 1.029 and the intercept was \u22120.009, demonstrating good agreement between the predicted risk and observed incidence of placental dysfunction\u2010related antepartum stillbirth. The performance of screening was better for placental dysfunction\u2010related antepartum stillbirth at &lt;\u200937\u2009weeks' gestation compared to at term (DR at a 10% FPR, 69.8% <jats:italic>vs<\/jats:italic> 29.2%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Screening at mid\u2010gestation by a combination of maternal risk factors, EFW and UtA\u2010PI can predict a high proportion of placental dysfunction\u2010related stillbirths and, in particular, those that occur preterm. Such screening provides poor prediction of unexplained stillbirth or stillbirth due to other causes. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.24795","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T20:38:43Z","timestamp":1634157523000},"page":"61-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Development and validation of model for prediction of placental dysfunction\u2010related stillbirth from maternal factors, fetal weight and uterine artery Doppler at mid\u2010gestation"],"prefix":"10.1002","volume":"59","author":[{"given":"G.","family":"Ashoor","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-1435","authenticated-orcid":false,"given":"I.","family":"Papastefanou","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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