{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T03:11:17Z","timestamp":1771211477745,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.pericles-gcp.literatumonline.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the association between undetected small\u2010for\u2010gestational age (SGA) fetuses and abnormal admission cardiotocography (admCTG) in a low\u2010risk population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>An observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Four hospitals in Stockholm\u2010Gotland, Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A cohort of 127\u2009461 deliveries between 1 February 2012 and 15 June 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cohort was linked to the Swedish Neonatal Quality Register. Pregnancies were designated as high or low risk at the time of admission to the labour ward according to pre\u2010defined risk measures. SGA was defined as a birthweight at or below the tenth centile and at or below the third centile for gestational age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The main outcome was the proportion of undetected SGA by admCTG (normal or abnormal). The secondary outcome was a composite severe adverse neonatal outcome for fetuses born less than 6\u2009hours after admission (Apgar score &lt;4 at 5\u2009minutes, hypoxic\u2013ischaemic encephalopathy grade of 2\u20133, neonatal seizures and neonatal death).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rate of abnormal admCTG was 4.9%. The proportion of SGA at or below the tenth centile was higher in the abnormal admCTG group than in the normal admCTG group, 18.6% versus 9.7% (odds ratio 2.1, 95% CI 1.9\u20132.3).<\/jats:p><jats:p>Abnormal admCTG and SGA (\u226410th) was associated with a more than 20\u2010fold increased risk of an adverse outcome compared with normal admCTG and non\u2010SGA (adjusted odds ratio 23.7, 95% CI 9.8\u201357.3). The latter had a risk of 1\/2000 of an adverse outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this low\u2010risk population, undetected SGA fetuses were more prone to having abnormal admCTG and had a substantially higher risk of severe adverse neonatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17504","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T03:45:39Z","timestamp":1682480739000},"page":"1412-1420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The association between undetected small\u2010for\u2010gestational age and abnormal admission cardiotocography: A registry\u2010based study"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9677-2272","authenticated-orcid":false,"given":"Erika","family":"Gyllencreutz","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Obstetrics and Gynaecology, \u00d6stersund Hospital Region J\u00e4mtland H\u00e4rjedalen  \u00d6stersund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingela Hulth\u00e9n","family":"Varli","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Medical Unit Pregnancy and Childbirth Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kari","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Clinical Epidemiology Division, Department of Medicine Solna Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-8235","authenticated-orcid":false,"given":"Pelle G.","family":"Lindqvist","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-0753","authenticated-orcid":false,"given":"Malin","family":"Holzmann","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Medical Unit Pregnancy and Childbirth Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"issue":"6","key":"e_1_2_12_2_1","first-page":"800","article-title":"Admission test: a screening test for fetal distress in labor","volume":"68","author":"Ingemarsson I","year":"1986","journal-title":"Obstet Gynecol"},{"key":"e_1_2_12_3_1","volume-title":"Intrapartum care: Care of Healthy Women and Their Babies during Childbirth","author":"National Collaborating Centre for Women's and Children's Health","year":"2014"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12091"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.06.020"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12464-6"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7300.1457"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-6138(03)00020-2"},{"key":"e_1_2_12_9_1","first-page":"18","article-title":"The effect of the labour electronic fetal monitoring admission test on operative delivery in low\u2010risk women: a randomised controlled trial. evidence\u2010based","volume":"6","author":"Mitchell K","year":"2008","journal-title":"Midwifery"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14296"},{"key":"e_1_2_12_11_1","unstructured":"2015. 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