Akolekar R, et al. - Via performing this prospective study of 45,847 singleton pregnancies, researchers primarily investigated the contribution of small for gestational age (SGA) fetuses to the overall rate of adverse perinatal outcome and secondarily, they sought to propose a two-stage approach that may assist in predicting SGA neonates at routine ultrasound examination at 35⁺⁰ - 36⁺⁶ weeks’ gestation. Based on findings of estimated fetal weight (EFW) and Doppler indices, the presented approach stratified the pregnancies undergoing routine ultrasound examination at 35⁺⁰ - 36⁺⁶ weeks’ gestation into four management groups. First, despite an increased risk of adverse perinatal outcome in babies with low birthweight (<10th percentile), the group with birthweight ≥10th percentile encounter 84% of adverse perinatal events. Second, in screening by EFW <10th percentile, modest predictive performance for SGA neonates was noted for those born at ≤2 weeks of assessment (83% and 69% for neonates with birthweight <3rd and <10th percentiles, respectively), but the performance was poor for those born at 2.1-4 weeks (61% and 45%) and >4 (40% and 30%) from assessment. Third, particularly for those delivering after two weeks from assessment, they noted potential achievement of improved performance of screening by a proposed new approach for stratifying pregnancies into management groups based on findings of EFW and Doppler indices (prediction of birthweight <3rd and <10th percentiles for deliveries at ≤ 2, 2.1-4 and >4 weeks from assessment: 89% and 75%, 83% and 74% and 88% and 82%, respectively). Fourth, they observed very poor predictive performance for adverse perinatal outcome of EFW <10th percentile (26%, 9% and 5% for deliveries at ≤ 2, 2.1-4 and >4 weeks from assessment, respectively) and the proposed new approach improved the performance (31%, 22% and 29%).