{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:05:52Z","timestamp":1774976752696,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["023.018.034"],"award-info":[{"award-number":["023.018.034"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["209030001"],"award-info":[{"award-number":["209030001"]}],"id":[{"id":"10.13039\/501100001826","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":[[2023,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To examine the implications of third\u2010trimester small\u2010for\u2010gestational\u2010age (SGA) screening accuracy on severe adverse perinatal outcome (SAPO) and obstetric intervention in a low\u2010risk population. Furthermore, we aimed to explore the additive value of third\u2010trimester sonographic growth\u2010trajectory measurements in predicting SAPO and obstetric intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a secondary analysis of a Dutch national multicenter stepped\u2010wedge\u2010cluster randomized trial among 11\u2009820 low\u2010risk pregnant women. Using multilevel multivariable logistic regression analysis, we compared SAPO and obstetric interventions in SGA neonates with and without SGA suspected prenatally (true positives and false negatives) and non\u2010SGA neonates with and without SGA suspected prenatally (false positives and true negatives). In a subsample (<jats:italic>n\u2009=<\/jats:italic>\u20097989), we analyzed the associations of abdominal circumference (AC) and estimated fetal weight (EFW) &lt;\u200910<jats:sup>th<\/jats:sup> centile (p10) and third\u2010trimester growth\u2010trajectory indicators AC and EFW crossing &gt;\u200920 and AC crossing &gt;\u200950\u2009centiles and the lowest decile of AC growth\u2010velocity <jats:italic>Z<\/jats:italic>\u2010scores (ACGV &lt;\u200910%) with SAPO and obstetric interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>SGA infants, i.e. the true\u2010positive and false\u2010negative cases, had an increased risk of SAPO (adjusted odds ratio (aOR), 4.46 (95%\u2009CI, 2.28\u20138.75) and aOR 2.61 (95%\u2009CI, 1.74\u20133.89), respectively), and obstetric intervention (aOR for: induction of labor, 2.99 (95%\u2009CI, 2.15\u20134.17) and 1.38 (95%\u2009CI, 1.14\u20131.66); Cesarean section, 1.82 (95%\u2009CI, 1.25\u20132.66) and 1.27 (95%\u2009CI, 1.05\u20131.54); medically indicated preterm delivery, 2.67 (95%\u2009CI, 1.97\u20133.62) and 1.20 (95%\u2009CI, 1.03\u20131.40)). The false\u2010positive cases did not differ from the true negatives for all outcomes, including obstetric intervention. Of the third\u2010trimester growth\u2010trajectory indicators, only ACGV &lt;\u200910% was associated moderately with SAPO (aOR, 2.15 (95%\u2009CI, 1.17\u20133.97)), while AC and EFW crossing &gt;\u200920 and AC crossing &gt;\u200950\u2009centiles were not. Both EFW\u2009&lt;\u2009p10 alone (aOR, 1.95 (95%\u2009CI, 1.13\u20133.38)) and EFW\u2009&lt;\u2009p10 combined with ACGV\u2009&lt;\u200910% (aOR, 4.69 (95%\u2009CI, 1.99\u201311.07)) were associated with SAPO, and they performed equally well in predicting SAPO (area under the receiver\u2010operating\u2010characteristics curve, 0.71 (95%\u2009CI, 0.65\u20130.76) <jats:italic>vs<\/jats:italic> 0.72 (95%\u2009CI, 0.67\u20130.77), <jats:italic>P\u2009=<\/jats:italic>\u20090.51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neonates who had been suspected falsely of being SGA during pregnancy had no higher rates of obstetric intervention than did those without suspicion of SGA prenatally. Our results do not support that third\u2010trimester low fetal growth velocity (ACGV\u2009&lt;\u200910%) may be of additive value for the identification of fetuses at risk of SAPO in populations remaining at low risk throughout pregnancy. AC and EFW crossing &gt;\u200920 and AC crossing &gt;\u200950 centiles performed poorly in identifying abnormal fetal growth. \u00a9 2023 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26167","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T09:24:03Z","timestamp":1674811443000},"page":"209-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Implication of third\u2010trimester screening accuracy for small\u2010for\u2010gestational age and additive value of third\u2010trimester growth\u2010trajectory indicators in predicting severe adverse perinatal outcome in low\u2010risk population: pragmatic secondary analysis of <scp>IRIS<\/scp> study"],"prefix":"10.1002","volume":"62","author":[{"given":"M.","family":"van Roekel","sequence":"first","affiliation":[{"name":"Amsterdam UMC, location Vrije Universiteit, Department of Midwifery Science\/AVAG Amsterdam Reproduction &amp; Development Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Henrichs","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, location Vrije Universiteit, Department of Midwifery Science\/AVAG Amsterdam Reproduction &amp; Development Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Franx","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. J.","family":"Verhoeven","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, location Vrije Universiteit, Department of Midwifery Science\/AVAG Amsterdam Reproduction &amp; Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of Midwifery University of Nottingham  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, location Vrije Universiteit, Department of Midwifery Science\/AVAG Amsterdam Reproduction &amp; Development Research Institute  Amsterdam The Netherlands"},{"name":"Amsterdam UMC, location Vrije Universiteit, Department of Midwifery Science\/AVAG Amsterdam Public Health Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,5]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Royal College of Obstetricians & Gynaecologists.The investigation and management of the small\u2010for\u2010gestational\u2010age fetus [Internet]. 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