Conclusions
This study found that although, on average, lower EFW percentiles on the INTERGROWTH-21st and WHO population fetal growth references are associated with increased risks of adverse child neurodevelopment at kindergarten age, they are not accurate individual-level predictors of adverse child development, across a broad range of possible percentile cut-points. Our findings support recent calls to shift away from the reliance on fetal size percentiles for identifying growth restriction, and adopt a more comprehensive, multi-faceted approach to risk assessment.