{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:54:57Z","timestamp":1790578497796,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop antenatal prediction models for shoulder dystocia and birth trauma using routinely collected maternal and sonographic variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single tertiary referral centre in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population or Sample<\/jats:title>\n                    <jats:p>All singleton term liveborn pregnancies delivered between January 2016 and November 2024 with a third\u2010trimester ultrasound performed at or beyond 36\u2009weeks' gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Multivariable logistic regression was used to develop antenatal prediction models for shoulder dystocia and birth trauma, incorporating maternal characteristics and fetal biometry including abdominal circumference (AC; centile or mm) and estimated fetal weight (EFW; grams or centile). Model performance was assessed using tests for multicollinearity, discrimination (area under the ROC curve, AUC) and calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Shoulder dystocia and birth trauma, the latter defined as a composite of shoulder dystocia, postpartum haemorrhage requiring blood transfusion, caesarean delivery at full dilatation, or hypoxic\u2013ischaemic encephalopathy (HIE \u2265\u20091).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 24\u2009334 singleton term pregnancies were included; 432 (1.8%) were complicated by shoulder dystocia and 1210 (5.0%) by birth trauma. The model including maternal characteristics and AC centile demonstrated the best discrimination. For shoulder dystocia, the apparent AUC was 0.706 (95% CI 0.682\u20130.730); the optimism\u2010corrected AUC after bootstrap validation was 0.699. For birth trauma, the apparent AUC was 0.669 (95% CI 0.654\u20130.685); the optimism\u2010corrected AUC was 0.665. At a 10% false\u2010positive rate, sensitivity was 31.5% for shoulder dystocia and 22.8% for birth trauma, compared with 20.4% and 14.0%, respectively, using EFW \u2265\u200990th centile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Antenatal models combining fetal AC centile with maternal risk factors outperform EFW\u2010based thresholds currently used in clinical practice. Although discrimination was modest, the model may be useful for antenatal risk stratification and counselling, rather than as a stand\u2010alone clinical test. Such models may help identify pregnancies at increased risk of delivery\u2010related complications associated with fetal overgrowth and inform future studies evaluating targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70250","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T03:01:08Z","timestamp":1776913268000},"page":"1996-2002","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Antenatal Prediction of Shoulder Dystocia and Birth Trauma Using Routine Maternal and Ultrasound Variables: Retrospective Cohort Study"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0161-8932","authenticated-orcid":false,"given":"Anat","family":"Schwartz","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit St. George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8681-4501","authenticated-orcid":false,"given":"Monica","family":"Minopoli","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St. George's University Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Di Ilio","sequence":"additional","affiliation":[{"name":"Department of Women's and Child Health Sciences and Public Health IRCCS A. Gemelli University Polyclinic Foundation  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-3393","authenticated-orcid":false,"given":"Daniele","family":"Di Mascio","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaranth","family":"Bhide","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St. George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St. George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"Basky","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St. George's University Hospitals NHS Foundation Trust  London UK"},{"name":"Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute St. George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27643"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20279"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.01.019"},{"key":"e_1_2_12_5_1","unstructured":"Royal College of Obstetricians and Gynaecologists \u201cShoulder Dystocia [Green\u2010Top Guideline] \u201d Report No. 42 (Royal College of Obstetricians and Gynaecologists 2012) https:\/\/www.rcog.org.uk."},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","unstructured":"American College of Obstetricians and Gynecologists \u201cMacrosomia: ACOG Practice Bulletin Number 216 [Practice Bulletin] [Internet] \u201d Report No. 216 (American College of Obstetricians and Gynecologists 2020) e18\u2013e35 https:\/\/www.acog.org.","DOI":"10.1097\/AOG.0000000000003606"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)61904\u20108"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000938.pub2"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26305"},{"key":"e_1_2_12_10_1","unstructured":"National Institute for Health and Care Excellence \u201cInducing Labour [Internet] \u201d Report No. (National Institute for Health and Care Excellence [NICE] 2021) https:\/\/www.nice.org.uk\/guidance\/ng207."},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(25)00162\u2010X"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.06.008"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.17802"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17491"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20377"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002\u20109378(85)90298\u20104"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(14)61490\u20102"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7992"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003190"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21878"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21929"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103366"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; 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