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Objective: To investigate the role of the cerebroplacental ratio (CPR) and other ultrasonographic parameters associated with adverse neonatal outcomes in a cohort of singleton pregnancies at 40-41 weeks of gestation. Methods: This prospective study included patients who attended the obstetric unit of a tertiary hospital at 40 0/7 and 40 6/7 weeks of gestation. A fetal Doppler ultrasound including the umbilical artery (UA) pulsatility index (PI) and middle cerebral artery (MCA) PI, placental calcification, fetal biometry and amniotic fluid index (AFI) of the study population were recorded. All patients were followed up until delivery. Umbilical pH <7.20, Apgar score <7 at the 5th minute, transfer of newborn to the nonatal intensive care unit, and cesarean section due to non-reassuring fetal status were considered as adverse neonatal outcomes. Results: MCA PI and CPR were lower in the adverse neonatal outcome group compared with the control group (1.14±0.19 vs. 1.25±0.27; p=0.046 and 1.44±0.33 vs. 1.62±0.45; p=0.049, respectively). The mean birthweight and percentile for GA were lower in women with adverse neonatal outcomes (3371±396 vs. 3548±449, p=0.034; 45.21±26.93 vs. 59.4±27.06, p=0.011). Polyhydramnios during Doppler ultrasound examination (OR:6.32), oligohydramnios at hospitalization (OR:4.78), and fetal birthweight percentile (OR:0.98) for GA at birth were found as significant variables to predict adverse neonatal outcomes. Conclusion: CPR may not be useful in prediction of adverse neonatal outcome at 40-41 weeks gestation. Fetal weight percentile for GA at birth and amniotic fluid abnormalities can help physicians predict adverse neonatal outcomes in women with pregnancies at 40-41 weeks gestation. [ABSTRACT FROM AUTHOR]