Introduction
Fetal growth restriction (FGR) refers that the fetus has not reached its growth potential due to the influence of certain factors (such as placenta, chromosomes, and infection etc.). It is the leading cause of intrauterine fetal death, neonatal death, and short-term and long-term complications worldwide (1; 2; 3). In clinical practice, it is difficult to evaluate the growth potential of a fetus, because it is not pragmatic to record the percentile of fetal biometrics and the estimated fetal weight (EFW) at different gestational weeks(4). In addition, the ability to predict the occurrence of adverse complications in a fetus due to FGR is relatively limited (5).
Therefore, different countries and associations have developed different guidelines to screen for fetuses with suspected FGR. The American College of Obstetrics and Gynecology (ACOG) defines FGR as an EFW less than the 10th percentile.(6). The Society of Maternal and Fetal Medicine (SMFM)(7) and the Royal College of Obstetrics and Gynecology (ROCG)(8) include abdominal circumference (AC) in the assessment. According to the Delphi consensus criteria, a consensus on the definition of FGR was established in cooperation with global experts.(9) The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) cited this definition to screen FGR.(10). The discuss on which definition is more practical has been a hot point in recent years(11; 12; 13; 14).
The purpose of this study was to compare the ability of different FGR definitions to predict small-for-gestational-age (SGA) and adverse neonatal outcomes (ANO), so as to figure out a more suitable definition for Chinese population.