{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:15:11Z","timestamp":1790363711130,"version":"4.1.0"},"reference-count":78,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T00:00:00Z","timestamp":1547683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Netherlands Organization for Health Research and Development, Pregnancy and Childbirth program","award":["209020007"],"award-info":[{"award-number":["209020007"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the external validity of all published first\u2010trimester prediction models based on routinely collected maternal predictors for the risk of small\u2010 and large\u2010for\u2010gestational\u2010age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content>) infants. Furthermore, the clinical potential of the best\u2010performing models was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Multicentre prospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Thirty\u2010six midwifery practices and six hospitals (in the Netherlands).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Pregnant women were recruited at &lt;16\u00a0weeks of gestation between 1 July 2013 and 31 December 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prediction models were systematically selected from the literature. Information on predictors was obtained by a web\u2010based questionnaire. Birthweight centiles were corrected for gestational age, parity, fetal sex, and ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Predictive performance was assessed by means of discrimination (C\u2010statistic) and calibration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The validation cohort consisted of 2582 pregnant women. The outcomes of <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> &lt;10th percentile and <jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content> &gt;90th percentile occurred in 203 and 224 women, respectively. The C\u2010statistics of the included models ranged from 0.52 to 0.64 for <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a06), and from 0.60 to 0.69 for <jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a06). All models yielded higher C\u2010statistics for more severe cases of <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> (&lt;5th percentile) and <jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content> (&gt;95th percentile). Initial calibration showed poor\u2010to\u2010moderate agreement between the predicted probabilities and the observed outcomes, but this improved substantially after recalibration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The clinical relevance of the models is limited because of their moderate predictive performance, and because the definitions of <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LGA<\/jats:styled-content> do not exclude constitutionally small or large infants. As most clinically relevant fetal growth deviations are related to \u2018vascular\u2019 or \u2018metabolic\u2019 factors, models predicting hypertensive disorders and gestational diabetes are likely to be more specific.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>The clinical relevance of prediction models for the risk of small\u2010 and large\u2010for\u2010gestational\u2010age is limited.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15516","type":"journal-article","created":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T10:13:05Z","timestamp":1540462385000},"page":"472-484","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["External validation and clinical usefulness of first\u2010trimester prediction models for small\u2010 and large\u2010for\u2010gestational\u2010age infants: a prospective cohort 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