# Late growth restriction is often missed before birth Bottleneck · id `maternal:bottleneck-late-fgr-detection` · Maternal & Newborn Atlas · release `fc5a600ec7387e71` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Pregnancy Browse, care area: The baby before birth ## In plain language Small babies are often not recognised before birth when scans are done only when there is a clinical reason. In one English study of first-time mothers, scans done only for clinical reasons found one in five babies who were later born small, while extra scans at 28 and 36 weeks found more than half. That study did not test whether acting on the extra scans helps babies. ## Technical summary In the Pregnancy Outcome Prediction cohort (Cambridge, 3977 nulliparous women), sensitivity for small-for-gestational-age (SGA, birth weight below the 10th percentile) was 20% with selective ultrasonography and 57% with hidden universal ultrasonography (relative sensitivity 2.9). SGA includes healthy small babies, so this measures detection of small size, not of pathological growth restriction; the study also found that SGA risk was raised mainly when abdominal circumference growth velocity was in the lowest decile. Funders include GE Healthcare. ## Claims, with the population each applies to ## Context: Fetuses of nulliparous women scanned at 28 and 36 weeks in one UK hospital (POP study) Recipient: Fetal; Population: Fetuses of nulliparous women with a viable singleton pregnancy at the dating scan who attended research scans and had a livebirth at the Rosie Hospital, Cambridge. 4512 women consented and 3977 (88%) were eligible for analysis. The women are the people recruited; the fetuses are the people scanned and then classified by birth weight.; Care setting: One UK teaching hospital; research ultrasound at 28 and 36 weeks of gestation alongside routine care; Geography: United Kingdom (Cambridge); Life stage: Pregnancy, third trimester scans at 28 and 36 weeks; births after the 28-week scan; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Birth weight for gestational age and neonatal morbidity ### In the Pregnancy Outcome Prediction cohort in Cambridge, nulliparous women with a viable singleton pregnancy had clinically indicated third-trimester ultrasound as usual (selective ultrasonography) and, in addition, research ultrasound with fetal biometry at 28 and 36 weeks whose results were not shown to women or clinicians (universal ultrasonography). Among 3977 women eligible for analysis, sensitivity for detecting small-for-gestational-age (SGA) infants, defined as birth weight below the 10th percentile, was 20% (69 of 352) with selective ultrasonography and 57% (199 of 352) with universal ultrasonography (relative sensitivity 2.9, 95% CI 2.4 to 3.5). The authors say universal third-trimester biometry roughly tripled detection of SGA infants. A fetus with an estimated weight below the 10th percentile had an increased risk of neonatal morbidity (relative risk 1.60, 95% CI 1.22 to 2.09), but only if the abdominal circumference growth velocity was in the lowest decile (relative risk 3.9, 95% CI 1.9 to 8.1). - Category: Description - Evidence stage: Observational - Certainty: Certainty not assessed - Applies to: Recipient: Fetal; Population: Fetuses of nulliparous women with a viable singleton pregnancy at the dating scan who attended research scans and had a livebirth at the Rosie Hospital, Cambridge. 4512 women consented and 3977 (88%) were eligible for analysis. The women are the people recruited; the fetuses are the people scanned and then classified by birth weight.; Care setting: One UK teaching hospital; research ultrasound at 28 and 36 weeks of gestation alongside routine care; Geography: United Kingdom (Cambridge); Life stage: Pregnancy, third trimester scans at 28 and 36 weeks; births after the 28-week scan; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Birth weight for gestational age and neonatal morbidity - Limitations: SGA is a birth-weight measure and includes healthy small babies, so it is not the same as growth restriction. The study scanned nulliparous women at one hospital, and the research results were hidden, so it did not test whether acting on universal scanning improves outcomes for babies. The study funders include GE Healthcare, a maker of ultrasound equipment (PubMed funding statement). The linked erratum (PMID 28831976) was read: it corrects the declaration of interests, which now lists other support from GE for one author, and it does not change the figures cited here. Only the abstract was read. - Last checked: 2026-10-14 - Source problem: a cited source is corrected. Check the sources before relying on this claim. - Sources: 1. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 1, fragment 1 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 2. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 1, fragment 2 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 3. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 4. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 3. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 5. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 4. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 6. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 5, fragment 1 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 7. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, METHODS, sentence 5, fragment 2 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 8. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 1. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 9. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 2, fragment 1 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 10. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 2, fragment 2 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 11. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 3, fragment 1 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 12. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 3, fragment 2 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 13. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 4, fragment 1 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 14. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FINDINGS, sentence 4, fragment 2 of 2. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 15. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, INTERPRETATION, sentence 1. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 16. Supports: Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities, retrieved 2026-10-14. The full text and the version of record were not read.) Locator: Abstract, FUNDING, sentence 1. Retrieved 2026-10-14T18:18:37Z. Source state: Corrected. Snapshot hash: 88b79713119757d5834460a938b74e852129b2188446669122bdd3d365f0f3ea. How it applies: PubMed abstract. 17. Background: Department of Error (Publication, edition PMC Open Access subset article (a published correction), full-text XML from NCBI E-utilities, retrieved 2026-10-14.) Locator: Body, paragraph 1, sentence 1, fragment 1 of 2. Retrieved 2026-10-14T18:48:43Z. Source state: Current. Snapshot hash: 9532203234cb27ec1e7b0a6e41d06939dfe040c9119edc63a611049b5d70de64. How it applies: Frames the population or setting. Source page. 18. Background: Department of Error (Publication, edition PMC Open Access subset article (a published correction), full-text XML from NCBI E-utilities, retrieved 2026-10-14.) Locator: Body, paragraph 1, sentence 1, fragment 2 of 2. Retrieved 2026-10-14T18:48:43Z. Source state: Current. Snapshot hash: 9532203234cb27ec1e7b0a6e41d06939dfe040c9119edc63a611049b5d70de64. How it applies: Frames the population or setting. Source page. ## Connected pages - Detection near term: Fetal growth restriction (fetus) (`maternal:fetal-growth-restriction`) - Filed under this front: Imaging and monitoring (`maternal:front-imaging-and-monitoring`) - Addressed by: Pregnancy ultrasound (`maternal:obstetric-ultrasound`) ## Provenance Content hash: 2eb9bb0c611f4b1e27f3c0e5b8de7521e9b2c456f45cb00e29a80b1ab1612995 Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14