{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T14:39:22Z","timestamp":1783003162591,"version":"3.54.5"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"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":[[2022,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the performance of severe smallness in the prediction of adverse perinatal outcome among fetuses with suspected late\u2010onset small\u2010for\u2010gestational age (SGA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was performed to identify relevant studies in PubMed, Web of Science and Scopus. Late\u2010onset SGA was defined as estimated fetal weight (EFW) or abdominal circumference (AC) &lt;\u200910<jats:sup>th<\/jats:sup> percentile diagnosed at or after 32\u2009weeks' gestation, while severe SGA was defined as EFW or AC &lt;\u20093<jats:sup>rd<\/jats:sup> percentile or &lt;\u20092 SD. Random\u2010effects modeling was used to generate hierarchical summary receiver\u2010operating\u2010characteristics (HSROC) curves. The performance of severe SGA (as a presumptive diagnosis) in predicting adverse perinatal outcome among singleton pregnancies with suspected late\u2010onset SGA was expressed as area under the HSROC curve (AUC), sensitivity, specificity and positive\/negative likelihood ratios. The association between suspected severe SGA and adverse perinatal outcome was also assessed by random\u2010effects modeling using the Mantel\u2013Haenszel method and presented as odds ratio (OR). The non\u2010exposed group was defined as non\u2010severe SGA (EFW \u2265\u20093<jats:sup>rd<\/jats:sup> centile).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve cohort studies were included in this systematic review and meta\u2010analysis. The studies included a total of 3639 fetuses with suspected late\u2010onset SGA, of which 1246 had suspected severe SGA. Significant associations were found between suspected severe SGA and composite adverse perinatal outcome (OR, 1.97 (95%\u2009CI, 1.33\u20132.92)), neonatal intensive care unit admission (OR, 2.87 (95%\u2009CI, 1.84\u20134.47)) and perinatal death (OR, 4.26 (95%\u2009CI, 1.07\u201316.93)). However, summary ROC curves showed limited performance of suspected severe SGA in predicting perinatal outcomes, with AUCs of 60.9%, 66.9%, 53.6%, 57.2%, 54.6% and 64.9% for composite adverse perinatal outcome, neonatal intensive care unit admission, neonatal acidosis, Cesarean section for intrapartum fetal compromise, low Apgar score and perinatal death, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although suspected severe SGA was associated with a higher risk of perinatal complications, it performed poorly as a standalone parameter in predicting adverse perinatal outcome. \u00a9 2022 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.24977","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T14:43:21Z","timestamp":1656081801000},"page":"328-337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Severe smallness as predictor of adverse perinatal outcome in suspected late small\u2010for\u2010gestational\u2010age fetuses: systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5975-9834","authenticated-orcid":false,"given":"E.","family":"Meler","sequence":"first","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecologia, Obstetr\u00edcia i Neonatologia Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-3857","authenticated-orcid":false,"given":"R. J.","family":"Martinez\u2010Portilla","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecologia, Obstetr\u00edcia i Neonatologia Universitat de Barcelona  Barcelona Spain"},{"name":"Clinical Research Branch National Institute of Perinatology  Mexico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Caradeux","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit Cl\u00ednica Santa Mar\u00eda  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Mazarico","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecologia, Obstetr\u00edcia i Neonatologia Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Gil\u2010Armas","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecologia, Obstetr\u00edcia i Neonatologia Universitat de Barcelona  Barcelona Spain"},{"name":"National Maternal Perinatal Institute  Lima Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Boada","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Center, BCNatal, Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u), Institut Cl\u00ednic de Ginecologia, Obstetr\u00edcia i Neonatologia Universitat de Barcelona  Barcelona 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