{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:57:58Z","timestamp":1769000278140,"version":"3.49.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","funder":[{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275200800013C"],"award-info":[{"award-number":["HHSN275200800013C"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275200800002I"],"award-info":[{"award-number":["HHSN275200800002I"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN27500006"],"award-info":[{"award-number":["HHSN27500006"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275200800003IC"],"award-info":[{"award-number":["HHSN275200800003IC"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275200800014C"],"award-info":[{"award-number":["HHSN275200800014C"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275200800012C"],"award-info":[{"award-number":["HHSN275200800012C"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275200800028C"],"award-info":[{"award-number":["HHSN275200800028C"]}]},{"name":"Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development","award":["HHSN275201000009C"],"award-info":[{"award-number":["HHSN275201000009C"]}]},{"name":"Grand Challenge Exploration Grant (GCE) from the Bill and Melinda Gates Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>\n            Objective\u2003The objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction.<\/jats:p><jats:p>\n            Study Design\u2003We developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We evaluated cross-sectional FH measurement \u2264 \u20133\u2009cm at visit 3 (mean: 32.0\u2009\u00b1\u20091.6 weeks) versus the addition of longitudinal FH up to and including visit 3 to trigger an ultrasound to diagnose SGA defined as birth weight &lt;10th percentile. If the FH cut points were not met, the SGA screen was classified as negative. If FH cut points were met and EFW was &lt;10th percentile, the SGA screen was considered positive. If EFW was \u226510th percentile, the SGA screen was also considered negative. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were computed.<\/jats:p><jats:p>\n            Results\u2003In a comparison of methods, 5.8% of women were classified as at risk of SGA by both cross-sectional and longitudinal classification methods; cross-sectional FH identified an additional 4.0%, and longitudinal fundal height identified a separate, additional 4.5%.<\/jats:p><jats:p>Using cross-sectional FH as an ultrasound trigger, EFW had a PPV and NPV for SGA of 69 and 92%, respectively. After adding longitudinal FH, PPV increased to 74%, whereas NPV of 92% remained unchanged; however, the number of women who underwent triggered EFW decreased from 9.7 to 5.7%.<\/jats:p><jats:p>\n            Conclusion\u2003An innovative approach for calculating longitudinal FH to the standard cross-sectional FH improved identification of SGA birth weight, while simultaneously reducing the number of triggered ultrasounds. As an essentially free-of-charge screening test, our novel method has potential to decrease costs as well as perinatal morbidity and mortality (through better prediction of SGA).<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1728837","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T22:52:08Z","timestamp":1620082328000},"page":"155-162","source":"Crossref","is-referenced-by-count":2,"title":["Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0276-8534","authenticated-orcid":false,"given":"Katherine L.","family":"Grantz","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana M.","family":"Ortega-Villa","sequence":"additional","affiliation":[{"name":"Biostatistics Research Branch, Division Clinical Research, National Institute of Allergy and Infectious Diseases, Fishers Lane, Rockville, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah J.","family":"Pugh","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaina","family":"Bever","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Grobman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger B.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Owen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The University of Alabama at Birmingham Center for Women's Reproductive Health, Birmingham, Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah A.","family":"Wing","sequence":"additional","affiliation":[{"name":"Department of Obstetrics-Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine, School of Medicine, Orange, California"},{"name":"Miller Children's Hospital\/Long Beach Memorial Medical Center, Long Beach, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul S.","family":"Albert","sequence":"additional","affiliation":[{"name":"Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"issue":"04","key":"ref1","first-page":"409","article-title":"Small for gestational age: the differential mortality when detected versus undetected antenatally","volume":"34","author":"J C Larkin","year":"2017","journal-title":"Am J Perinatol"},{"key":"ref2","volume-title":"WHO Recommendation on Symphysis-Fundal Height Measurement","author":"World Health Organization","year":"2018"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1097\/AOG.0000000000003070","article-title":"ACOG practice bulletin no. 204: fetal growth restriction","volume":"133","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Obstetrics and the Society for Maternal-FetalMedicin","year":"2019","journal-title":"Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12884-015-0461-z","article-title":"Symphysis-fundus height measurement to predict small-for-gestational-age status at birth: a systematic review","volume":"15","author":"A S Pay","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ijgo.2009.11.023","article-title":"Inadequate identification of small-for-gestational-age fetuses at an urban teaching hospital","volume":"109","author":"K P Mattioli","year":"2010","journal-title":"Int J Gynaecol Obstet"},{"issue":"03","key":"ref6","first-page":"187","article-title":"Prenatal detection of fetal growth restriction in newborns classified as small for gestational age: correlates and risk of neonatal morbidity","volume":"31","author":"S P Chauhan","year":"2014","journal-title":"Am J Perinatol"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/1471-0528.13148","article-title":"Poor effectiveness of antenatal detection of fetal growth restriction and consequences for obstetric management and neonatal outcomes: a French national study","volume":"122","author":"I Monier","year":"2015","journal-title":"BJOG"},{"issue":"06","key":"ref8","first-page":"CD001451","article-title":"Routine ultrasound in late pregnancy (after 24 weeks' gestation)","author":"L Bricker","year":"2015","journal-title":"Cochrane Database Syst 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height","volume":"28","author":"A Griffiths","year":"2008","journal-title":"J Obstet Gynaecol"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/AOG.0000000000000345","article-title":"A revised birth weight reference for the United States","volume":"124","author":"E L Duryea","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0301-2115(96)02643-7","article-title":"Predictive value of conditional centile charts for weight and fundal height in pregnancy in detecting light for gestational age births","volume":"72","author":"M L Thompson","year":"1997","journal-title":"Eur J Obstet Gynecol Reprod Biol"}],"container-title":["American Journal of 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