{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:33:12Z","timestamp":1791819192079,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the external validity of the Fetal Medicine Foundation (FMF) competing\u2010risks model for the prediction of small\u2010for\u2010gestational age (SGA) at 11\u201314\u2009weeks' gestation in an Asian population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a secondary analysis of a multicenter prospective cohort study in 10\u2009120 women with a singleton pregnancy undergoing routine assessment at 11\u201314\u2009weeks' gestation. We applied the FMF competing\u2010risks model for the first\u2010trimester prediction of SGA, combining maternal characteristics and medical history with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI) and serum placental growth factor (PlGF) concentration. We calculated risks for different cut\u2010offs of birth\u2010weight percentile (&lt;\u200910<jats:sup>th<\/jats:sup>, &lt;\u20095<jats:sup>th<\/jats:sup> or &lt;\u20093<jats:sup>rd<\/jats:sup> percentile) and gestational age at delivery (&lt;\u200937\u2009weeks (preterm SGA) or SGA at any gestational age). Predictive performance was examined in terms of discrimination and calibration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The predictive performance of the competing\u2010risks model for SGA was similar to that reported in the original FMF study. Specifically, the combination of maternal factors with MAP, UtA\u2010PI and PlGF yielded the best performance for the prediction of preterm SGA with birth weight &lt;\u200910<jats:sup>th<\/jats:sup> percentile (SGA &lt;\u200910<jats:sup>th<\/jats:sup>) and preterm SGA with birth weight &lt;\u20095<jats:sup>th<\/jats:sup> percentile (SGA &lt;\u20095<jats:sup>th<\/jats:sup>), with areas under the receiver\u2010operating\u2010characteristics curve (AUCs) of 0.765 (95%\u2009CI, 0.720\u20130.809) and 0.789 (95%\u2009CI, 0.736\u20130.841), respectively. Combining maternal factors with MAP and PlGF yielded the best model for predicting preterm SGA with birth weight &lt;\u20093<jats:sup>rd<\/jats:sup> percentile (SGA &lt;\u20093<jats:sup>rd<\/jats:sup>) (AUC, 0.797 (95%\u2009CI, 0.744\u20130.850)). After excluding cases with pre\u2010eclampsia, the combination of maternal factors with MAP, UtA\u2010PI and PlGF yielded the best performance for the prediction of preterm SGA &lt;\u200910<jats:sup>th<\/jats:sup> and preterm SGA &lt;\u20095<jats:sup>th<\/jats:sup>, with AUCs of 0.743 (95%\u2009CI, 0.691\u20130.795) and 0.762 (95%\u2009CI, 0.700\u20130.824), respectively. However, the best model for predicting preterm SGA &lt;\u20093<jats:sup>rd<\/jats:sup> without pre\u2010eclampsia was the combination of maternal factors and PlGF (AUC, 0.786 (95%\u2009CI, 0.723\u20130.849)). The FMF competing\u2010risks model including maternal factors, MAP, UtA\u2010PI and PlGF achieved detection rates of 42.2%, 47.3% and 48.1%, at a fixed false\u2010positive rate of 10%, for the prediction of preterm SGA &lt;\u200910<jats:sup>th<\/jats:sup>, preterm SGA &lt;\u20095<jats:sup>th<\/jats:sup> and preterm SGA &lt;\u20093<jats:sup>rd<\/jats:sup>, respectively. The calibration of the model was satisfactory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The screening performance of the FMF first\u2010trimester competing\u2010risks model for SGA in a large, independent cohort of Asian women is comparable with that reported in the original FMF study in a mixed European population. \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.27447","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T11:59:41Z","timestamp":1691495981000},"page":"331-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of screening performance of first\u2010trimester competing\u2010risks prediction model for small\u2010for\u2010gestational age in Asian population"],"prefix":"10.1002","volume":"63","author":[{"given":"L.","family":"Nguyen\u2010Hoang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"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"},{"name":"Department of Women and Children's Health, Faculty of Life Sciences and Medicine King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3755-2701","authenticated-orcid":false,"given":"D. S.","family":"Sahota","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Pooh","sequence":"additional","affiliation":[{"name":"CRIFM Prenatal Medical Clinic  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Zheng","sequence":"additional","affiliation":[{"name":"Center for Obstetrics and Gynecology The Affiliated Drum Tower Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Chaiyasit","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology King Chulalongkorn Memorial Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-446X","authenticated-orcid":false,"given":"M.","family":"Tokunaka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Showa University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. W.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Taipei Chang Gung Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Seshadri","sequence":"additional","affiliation":[{"name":"Mediscan  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Choolani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National University Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Yapan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Siriraj Hospital  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. S.","family":"Sim","sequence":"additional","affiliation":[{"name":"Maternal\u2013Fetal Medicine KK Women's and Children's Hospital  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"L. C.","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Prince of Wales Hospital The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.05.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2021.09.008"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12802"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20105"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.018"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.11.1247"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.07.020"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2217\/epi-2016-0103"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20103"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(75)90011-3"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000388"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp-20-339"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.12.318"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22129"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23523"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21905"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.09.041"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6252"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2017.08.002"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5157"},{"key":"e_1_2_8_22_1","unstructured":"Fetal Medicine Foundation.Certificates of competence.https:\/\/www.fetalmedicine.org\/training\u2010certification\/certificates\u2010of\u2010competence\/preeclampsia\u2010screening\u20101[Accessed 20 November 2018]."},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5372"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(13)70006-8"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19112"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.19073"},{"key":"e_1_2_8_27_1","volume-title":"R: a language and environment for statistical computing","author":"R Core Development Team"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15516"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22175"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26285"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5001"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23118"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26210"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.27447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:56:50Z","timestamp":1756382210000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.27447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,5]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/uog.27447"],"URL":"https:\/\/doi.org\/10.1002\/uog.27447","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,5]]},"assertion":[{"value":"2023-03-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}