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This is a retrospective, cohort study led at a level IV Obstetric and Neonatal Unit in Bologna, Italy. Pregnant women were eligible if having singleton pregnancies, with no major foetal anomaly detected, and diagnosed with early FGR\u2009+\u2009AEDF (defined as FGR\u2009+\u2009AEDF detected before 32\u00a0weeks gestation). Early FGR\u2009+\u2009AEDF was further classified according to time of onset and specific features into very early and persistent (VEP, FGR\u2009+\u2009AEDF first detected at 20\u201324\u00a0weeks gestation and persistent at the following scans), very early but transient (VET, FGR\u2009+\u2009AEDF detected at 20\u201324\u00a0weeks gestation and progressively improving at the following scans) and later (LA, FGR\u2009+\u2009AEDF detected between 25 and 32\u00a0weeks gestation). Pregnancy and neonatal outcomes and infant follow-up data were collected and compared among groups. Neurodevelopment was assessed using the revised Griffiths Mental Developmental Scales (GMDS-R) 0\u20132\u00a0years. A regression analysis was performed to identify early predictors of preterm infants\u2019 neurodevelopmental impairment. Fifty-two pregnant women with an antenatal diagnosis of early FGR\u2009+\u2009AEDF were included in the study (16 VEP, 14 VET, 22 LA). Four intrauterine foetal deaths occurred, all in the VEP group (<jats:italic>p<\/jats:italic>\u2009=\u20090.010). Compared to LA infants, VEP infants were born with lower gestational age and lower birth weight, had lower arterial cord blood pH and were at higher risk for intraventricular haemorrhage and periventricular leukomalacia (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 for all comparisons). At 12\u00a0months, VEP infants had worse GMDS-R scores, both in the general quotient (mean [SD] 91.8 [12.4] vs 104.6 [8.7] in LA) and in the performance domain (mean [SD] 93.3 [15.4] vs 108.8 [8.8] in LA). This latter difference persisted at 24\u00a0months (mean [SD] 68.3 [17.0] vs 92.9 [17.7] in LA). In multivariate analysis, at 12\u00a0months corrected age, PVL was found to be an independent predictor of impaired general quotient, while the features and timing of antenatal Doppler alterations predicted worse scores in the performance domain. <\/jats:p><jats:p><jats:italic>\u00a0 Conclusion<\/jats:italic>:\u00a0Timing of onset and features of early FGR\u2009+\u2009AEDF might impact differently on neonatal clinical and neurodevelopmental outcomes. Shared awareness of the importance of FGR\u2009+\u2009AEDF features between obstetricians and neonatologists may offer valuable tools for antenatal counselling and for tailoring pregnancy management and neonatal follow-up in light of specific antenatal and neonatal risk factors.<\/jats:p><jats:p><jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold><jats:italic>\u2022 Foetal growth restriction (FGR), together with antenatal umbilical Doppler abnormalities, is known to affect maternal and neonatal outcomes.<\/jats:italic><jats:italic>\u2022 Infants born preterm and growth-restricted face the highest risk for neurodevelopmental impairment, especially when FGR occurs early during pregnancy (early FGR, before 32\u00a0weeks gestation).<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold><jats:italic>\u2022 The timing of onset and features of FGR and antenatal umbilical Doppler abnormalities impact differently on maternal and neonatal outcomes;\u00a0when FGR and Doppler abnormalities occur very early, at the limit of neonatal viability, and persist until delivery, infants face the highest risk for neurodevelopmental impairment.<\/jats:italic><jats:italic>\u2022 Shared knowledge between obstetricians and neonatologists about timing of onset and features of FGR would provide a valuable tool for informed antenatal counselling in high-risk pregnancies.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  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