{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:01:51Z","timestamp":1781247711940,"version":"3.54.1"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007406","name":"Fundaci\u00f3n BBVA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007406","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI18\/01749"],"award-info":[{"award-number":["PI18\/01749"]}],"id":[{"id":"10.13039\/501100004587","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":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine the predictive performance of the Fetal Medicine Foundation (FMF) competing\u2010risks model for the first\u2010trimester prediction of a small\u2010for\u2010gestational\u2010age (SGA) neonate in a large, independent, unselected European cohort and to compare the competing\u2010risks algorithm with previously published logistic\u2010regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective, non\u2010interventional, multicenter cohort study including 35\u2009170 women with a singleton pregnancy who underwent a first\u2010trimester ultrasound assessment between 11\u2009+\u20090 and 13\u2009+\u20096\u2009weeks' gestation. We used the default FMF competing\u2010risks model for the prediction of SGA combining maternal factors, uterine artery pulsatility index (UtA\u2010PI), pregnancy\u2010associated plasma protein\u2010A (PAPP\u2010A) and placental growth factor (PlGF) to obtain risks for different cut\u2010offs of birth\u2010weight percentile and gestational age at delivery. We examined the predictive performance in terms of discrimination and calibration and compared it with the published data on the model's development population and with published logistic\u2010regression equations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a 10% false\u2010positive rate, maternal factors and UtA\u2010PI predicted 42.2% and 51.5% of SGA &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      \u2009percentile delivered &lt;\u200937\u2009weeks and &lt;\u200932\u2009weeks, respectively. The respective values for SGA &lt;\u20093\n                      <jats:sup>rd<\/jats:sup>\n                      \u2009percentile were 44.7% and 51.7%. Also at a 10% false\u2010positive rate, maternal factors, UtA\u2010PI and PAPP\u2010A predicted 42.2% and 51.5% of SGA &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      \u2009percentile delivered &lt;\u200937\u2009weeks and &lt;\u200932\u2009weeks, respectively. The respective values for SGA &lt;\u20093\n                      <jats:sup>rd<\/jats:sup>\n                      \u2009percentile were 46.2% and 51.7%. At a 10% false\u2010positive rate, maternal factors, UtA\u2010PI, PAPP\u2010A and PlGF predicted 47.6% and 66.7% of SGA &lt;\u200910\n                      <jats:sup>th<\/jats:sup>\n                      \u2009percentile delivered &lt;\u200937\u2009weeks and &lt;\u200932\u2009weeks, respectively. The respective values for SGA &lt;\u20093\n                      <jats:sup>rd<\/jats:sup>\n                      percentile were 50.0% and 69.0%. These data were similar to those reported in the original model's development study and substantially better than those calculated using pre\u2010existing logistic\u2010regression models (McNemar's test,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The FMF competing\u2010risks model was well calibrated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The FMF competing\u2010risks model for the first\u2010trimester prediction of SGA is reproducible in an independent, unselected low\u2010risk cohort and superior to logistic\u2010regression approaches. \u00a9 2025 The Author(s).\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.29219","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T15:10:56Z","timestamp":1744643456000},"page":"729-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["External validation and comparison of\n                    <scp>Fetal Medicine Foundation<\/scp>\n                    competing\u2010risks model for small\u2010for\u2010gestational\u2010age neonate in the first trimester: multicenter cohort study"],"prefix":"10.1002","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8041-2181","authenticated-orcid":false,"given":"P.","family":"Chaveeva","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Shterev Hospital  Sofia Bulgaria"},{"name":"Medical University  Pleven Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-1435","authenticated-orcid":false,"given":"I.","family":"Papastefanou","sequence":"additional","affiliation":[{"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\/0000-0002-2863-5839","authenticated-orcid":false,"given":"T.","family":"Dagklis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Vali\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Complejo Hospitalario Universitario A Coru\u00f1a  A Coru\u00f1a Galicia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Revello","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Quir\u00f3n, Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Adiego","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario Fundaci\u00f3n de Alcorc\u00f3n, Alcorc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Delgado","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital Cl\u00ednico Universitario \u2018Virgen de la Arrixaca\u2019, El Palmar  Murcia Spain"},{"name":"Faculty of Medicine Universidad de Murcia  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Kalev","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, Shterev Hospital  Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4337-7871","authenticated-orcid":false,"given":"I.","family":"Tsakiridis","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Triano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario de Torrej\u00f3n, Torrej\u00f3n de Ardoz  Madrid Spain"},{"name":"Faculty of Medicine Universidad Francisco de Vitoria, Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Pertegal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital Cl\u00ednico Universitario \u2018Virgen de la Arrixaca\u2019, El Palmar  Murcia Spain"},{"name":"Faculty of Medicine Universidad de Murcia  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3066-9963","authenticated-orcid":false,"given":"A.","family":"Siargkas","sequence":"additional","affiliation":[{"name":"Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1817-3092","authenticated-orcid":false,"given":"B.","family":"Santacruz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitario de Torrej\u00f3n, Torrej\u00f3n de Ardoz  Madrid Spain"},{"name":"Faculty of Medicine Universidad Francisco de Vitoria, Pozuelo de Alarc\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0117-6388","authenticated-orcid":false,"given":"C.","family":"De Paco Matallana","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital Cl\u00ednico Universitario \u2018Virgen de la Arrixaca\u2019, El Palmar  Murcia Spain"},{"name":"Faculty of Medicine Universidad de Murcia  Murcia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9993-5249","authenticated-orcid":false,"given":"M. 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