{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:23Z","timestamp":1787004863498,"version":"build-2736575974"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Objective\u2003Fetal growth restriction (FGR) is defined as an estimated fetal weight (EFW) or abdominal circumference (AC) &lt;10th percentile (%ile) for gestational age (GA). An EFW &lt;3rd %ile for GA is considered severe FGR (sFGR). It remains unknown if fetuses with isolated AC &lt;3rd %ile should be considered sFGR. Our primary objective was to assess composite neonatal outcomes in fetuses with an AC &lt;3rd %ile and overall EFW 3rd to 9th %ile compared with those with an EFW &lt;3rd %ile.<\/jats:p>\n                  <jats:p>Study Design\u2003This retrospective cohort study was undertaken at a tertiary academic center from January 2016 to December 2021. Inclusion criteria were singleton fetuses with an EFW &lt;3rd %ile (Group 1) or AC &lt;3rd %ile with EFW 3rd to 9th %ile (Group 2) at 28 weeks' gestation or greater. Exclusion criteria were multiple gestations, presence of a major fetal anomaly, resolution of FGR, genetic syndrome, or infection. Composite neonatal outcome was defined by any of the following: neonatal intensive care unit admission &gt;48\u2009hours, necrotizing enterocolitis, sepsis, respiratory distress syndrome, mechanical ventilation, retinopathy of prematurity, seizures, intraventricular hemorrhage, stillbirth, or death before discharge. Small for gestational age (SGA) was defined as birth weight &lt;10th %ile for GA.<\/jats:p>\n                  <jats:p>Results\u2003A total of 743 patients fulfilled our study criteria, with 489 in Group 1 and 254 in Group 2. The composite neonatal outcome occurred in 281 (57.5%) neonates in Group 1 and 53 (20.9%) in Group 2 (p\u2009&lt;\u20090.01). The rates of SGA at birth were 94.9 and 75.6% for Group 1 and Group 2, respectively (OR 5.99, 95% confidence interval 3.65\u20139.82).<\/jats:p>\n                  <jats:p>Conclusion\u2003Although AC &lt;3rd %ile with EFW 3rd to 9th %ile is associated with a lower frequency of SGA and neonatal morbidity than EFW &lt;3 %ile, fetuses with AC &lt;3 %ile still exhibited moderate rates of these adverse perinatal outcomes. Consideration should be given to inclusion of an AC &lt;3rd %ile with EFW 3rd to 9th %ile as a criterion for sFGR. However, prospective studies comparing delivery at 37 versus 38 to 39 weeks' gestation are needed to ensure improved outcomes before widespread adaptation in clinical practice.<\/jats:p>\n                  <jats:p>Key Points<\/jats:p>","DOI":"10.1055\/a-2259-0148","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T18:57:21Z","timestamp":1706813841000},"page":"1120-1125","source":"Crossref","is-referenced-by-count":4,"title":["Neonatal Outcomes among Fetuses with an Abdominal Circumference &lt;3rd %ile and Estimated Fetal Weight 3rd to 9th %ile Compared to Fetuses with an EFW &lt;3rd %ile"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2752-4061","authenticated-orcid":false,"given":"Rebecca","family":"Horgan","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Nehme","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah J.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Saal","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-4684","authenticated-orcid":false,"given":"Kazuma","family":"Onishi","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-8979","authenticated-orcid":false,"given":"Juliana G.","family":"Martins","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.placenta.2015.03.003","article-title":"Animal models of fetal growth restriction: considerations for translational medicine","volume":"36","author":"A M Swanson","year":"2015","journal-title":"Placenta"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/S0002-9378(00)70513-8","article-title":"Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction","volume":"182","author":"I M Bernstein","year":"2000","journal-title":"Am J 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