ArticleBJOG : an international journal of obstetrics and gynaecology2019
External validation and clinical usefulness of first-trimester prediction models for small- and large-for-gestational-age infants: a prospective cohort study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- First-Trimester Prediction Models Based on Maternal Characteristics for Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2025Pooled it
- The association of first and second-trimester serum biomarkers with adverse perinatal outcomes in late-preterm and term deliveries: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Development and validation of super learner models to predict small and large for gestational age in the second generation.Scientific reports · 2025Article
- External validation and comparison of Fetal Medicine Foundation competing-risks model for small-for-gestational-age neonate in the first trimester: multicenter cohort study.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025Article
- Observational
- Assessment of first-trimester utero-placental vascular morphology by 3D power Doppler ultrasound image analysis using a skeletonization algorithm: the Rotterdam Periconception Cohort.Human reproduction (Oxford, England) · 2022Observational
- Cardiovascular Disease-Associated MicroRNAs as Novel Biomarkers of First-Trimester Screening for Gestational Diabetes Mellitus in the Absence of Other Pregnancy-Related Complications.International journal of molecular sciences · 2022Article
- Risk scores for predicting small for gestational age infants in Japan: The TMM birthree cohort study.Scientific reports · 2022Article
- Family socioeconomic position and abnormal birth weight: evidence from a Chinese birth cohort.World journal of pediatrics : WJP · 2019Article
- External validation and clinical usefulness of first-trimester prediction models for small- and large-for-gestational-age infants: a prospective cohort study.BJOG : an international journal of obstetrics and gynaecology · 2019Article
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Abstract
objectiveTo assess the external validity of all published first-trimester prediction models based on routinely collected maternal predictors for the risk of small- and large-for-gestational-age (SGA and LGA) infants. Furthermore, the clinical potential of the best-performing models was evaluated.
designMulticentre prospective cohort.
settingThirty-six midwifery practices and six hospitals (in the Netherlands). POPULATION: Pregnant women were recruited at <16 weeks of gestation between 1 July 2013 and 31 December 2015.
methodsPrediction models were systematically selected from the literature. Information on predictors was obtained by a web-based questionnaire. Birthweight centiles were corrected for gestational age, parity, fetal sex, and ethnicity.
main outcome measuresPredictive performance was assessed by means of discrimination (C-statistic) and calibration.
resultsThe validation cohort consisted of 2582 pregnant women. The outcomes of SGA <10th percentile and LGA >90th percentile occurred in 203 and 224 women, respectively. The C-statistics of the included models ranged from 0.52 to 0.64 for SGA (n = 6), and from 0.60 to 0.69 for LGA (n = 6). All models yielded higher C-statistics for more severe cases of SGA (<5th percentile) and LGA (>95th percentile). Initial calibration showed poor-to-moderate agreement between the predicted probabilities and the observed outcomes, but this improved substantially after recalibration.
conclusionThe clinical relevance of the models is limited because of their moderate predictive performance, and because the definitions of SGA and LGA do not exclude constitutionally small or large infants. As most clinically relevant fetal growth deviations are related to 'vascular' or 'metabolic' factors, models predicting hypertensive disorders and gestational diabetes are likely to be more specific. TWEETABLE ABSTRACT: The clinical relevance of prediction models for the risk of small- and large-for-gestational-age is limited.
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