{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:14:27Z","timestamp":1785161667858,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,2]],"date-time":"2023-12-02T00:00:00Z","timestamp":1701475200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The placental dysfunction underlying fetal growth restriction (FGR) may result in severe adverse perinatal outcome (SAPO) related to fetal hypoxia. Traditionally, the diagnostic criteria for FGR have been based on fetal size, an approach that is inherently flawed because it often results in either over\u2010 or underdiagnosis. The anomaly ultrasound scan at 20\u2009weeks' gestation may be an appropriate time at which to set a benchmark for growth potential of the individual fetus. We hypothesized that the fetal growth trajectory from that point onwards may be informative regarding third\u2010trimester placental dysfunction. The aim of this study was to investigate the predictive value for SAPO of a slow fetal growth trajectory between 18\u2009+\u20090 to 23\u2009+\u20096\u2009weeks and 32\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation in a large, low\u2010risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a\n                      <jats:italic>post\u2010hoc<\/jats:italic>\n                      data analysis of the IUGR Risk Selection (IRIS) study, a Dutch nationwide cluster\u2010randomized trial assessing the (cost\u2010)effectiveness of routine third\u2010trimester sonography in reducing SAPO. In the current analysis, for the first ultrasound examination we used ultrasound data from the routine anomaly scan at 18\u2009+\u20090 to 23\u2009+\u20096\u2009weeks' gestation, and for the second we used data from an ultrasound examination performed between 32\u2009+\u20090 and 36\u2009+\u20096\u2009weeks' gestation. Using multilevel logistic regression, we analyzed whether SAPO was predicted by a slow fetal growth trajectory, which was defined as a decline in abdominal circumference (AC) and\/or estimated fetal weight (EFW) of more than 20 percentiles or more than 50 percentiles or as an AC growth velocity (ACGV) &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      percentile (p10). In addition, we analyzed the combination of these indicators of slow fetal growth with small\u2010for\u2010gestational age (SGA) (AC or EFW &lt;\u2009p10) and severe SGA (AC\/EFW &lt;\u20093\n                      <jats:sup>rd<\/jats:sup>\n                      percentile) at 32\u2009+\u20090 to 36\u2009+\u20096\u2009weeks' gestation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our sample included the data of 6296 low\u2010risk singleton pregnancies, among which 82 (1.3%) newborns experienced at least one SAPO. Standalone declines in AC or EFW of &gt;\u200920 or &gt;\u200950 percentiles or ACGV &lt;\u2009p10 were not associated with increased odds of SAPO. EFW &lt;\u2009p10 between 32\u2009+\u20090 and 36\u2009+\u20096\u2009weeks'\u00a0gestation combined with a decline in EFW of &gt;\u200920\u2009percentiles was associated with an increased rate of SAPO. The combination of AC or EFW &lt;\u2009p10 between 32\u2009+\u20090 and 36\u2009+\u20096\u2009weeks' gestation with ACGV &lt;\u2009p10 was also associated with increased odds of SAPO. The odds ratios of these associations were higher if the neonate was SGA at birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In a low\u2010risk population, a slow fetal growth trajectory as a standalone criterion does not distinguish adequately between fetuses with FGR and those that are constitutionally small. This absence of association may be a result of diagnostic inaccuracies and\/or post\u2010diagnostic (e.g. intervention and selection) biases. We conclude that new approaches to detect placental insufficiency should integrate information from diagnostic tools such as maternal serum biomarkers and Doppler ultrasound measurements. \u00a9 2023 The Authors.\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.26250","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T10:08:16Z","timestamp":1684490896000},"page":"796-804","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Predictive value of fetal growth trajectory from 20\u2009weeks of gestation onwards for severe adverse perinatal outcome in low\u2010risk population: secondary analysis of\n                    <scp>IRIS<\/scp>\n                    study"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-2925","authenticated-orcid":false,"given":"H. D.","family":"Kamphof","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5697-526X","authenticated-orcid":false,"given":"M.","family":"van Roekel","sequence":"additional","affiliation":[{"name":"Department of Midwifery Science, Amsterdam University Medical Centers Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Midwifery Academy Amsterdam Groningen, InHolland  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of General Practice and Elderly Care Medicine University Medical Centre Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Henrichs","sequence":"additional","affiliation":[{"name":"Department of Midwifery Science, Amsterdam University Medical Centers Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Midwifery Academy Amsterdam Groningen, InHolland  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of General Practice and Elderly Care Medicine University Medical Centre Groningen, University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"de Vreede","sequence":"additional","affiliation":[{"name":"Department of Midwifery Science, Amsterdam University Medical Centers Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Verhoeven","sequence":"additional","affiliation":[{"name":"Department of Midwifery Science, Amsterdam University Medical Centers Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Midwifery Academy Amsterdam Groningen, InHolland  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Department of General Practice and Elderly Care Medicine University Medical Centre Groningen, University of Groningen  Groningen The Netherlands"},{"name":"Division of Midwifery, School of Health Sciences University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Franx","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Erasmus Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Department of Midwifery Science, Amsterdam University Medical Centers Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Midwifery Academy Amsterdam Groningen, InHolland  Amsterdam The Netherlands"},{"name":"Department of General Practice and Elderly Care Medicine University Medical Centre Groningen, University of Groningen  Groningen The Netherlands"},{"name":"Department of Obstetrics and Gynecology Amsterdam University Medical Centers, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-2115","authenticated-orcid":false,"given":"W.","family":"Ganzevoort","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3915-8609","authenticated-orcid":false,"given":"S. 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