title: Stillbirth and the small fetus: use of a sex-specific versus a non-sex-specific growth standard.
abstract: OBJECTIVE
  To determine if the use of a sex-specific standard to define small-for-gestational age (SGA) will improve prediction of stillbirth.
  
  
  METHODS
  We performed a retrospective cohort study of singleton pregnancies excluding anomalies, aneuploidy, undocumented fetal sex or birthweight. SGA was defined as birthweight <10th percentile by the non-sex-specific and sex-specific Alexander standards. The association between SGA and stillbirth using these standards was assessed using logistic regression.
  
  
  RESULTS
  Among 57,170 pregnancies meeting inclusion criteria, 319 (0.6%) pregnancies were complicated by stillbirth. The area under the receiver operating characteristic curve for the prediction of stillbirth was greater for the sex-specific compared to the non-sex-specific standard (0.83 vs 0.72, P<0.001).
  
  
  CONCLUSIONS
  Our findings suggest adoption of a sex-specific standard for diagnosis of SGA as it is more discriminative in identifying the SGA fetus at risk for stillbirth.
authors: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes Jewish Hospital Plaza, St Louis, MO, USA.
authors: A S
authors: AS
authors: Trudell
authors: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes Jewish Hospital Plaza, St Louis, MO, USA.
authors: A G
authors: AG
authors: Cahill
authors: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes Jewish Hospital Plaza, St Louis, MO, USA.
authors: M G
authors: MG
authors: Tuuli
authors: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes Jewish Hospital Plaza, St Louis, MO, USA.
authors: G A
authors: GA
authors: Macones
authors: Department of Obstetrics and Gynecology, University of South Florida 2 Tampa General Circle, Tampa, FL, USA.
authors: A O
authors: AO
authors: Odibo
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012743:Sex Preselection / Q000706:statistics & numerical data*; D050497:Stillbirth / Q000453:epidemiology*