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Yes, from my experience I think it's true. For instance, if you start a paragraph at the end of a page, and it ends on the next, the close tag will be on the second page.
But you see, most PDF files are saved as regular PDF, with objects that float around (including text, parts of text, or sometimes even individual letters). You can usually spot them right away if you select the text and there are all sorts of spaces between characters or entire groups of characters. These are very difficult to convert because each object (or groups of objects) have their own coordinates on the page.
On the other hand, there are tagged PDF files, which have open and close tags for objects, especially for text segments, making them (relatively) easier to convert - but not perfect. Keep in mind that PDF is considered an output format and as Will suggested, it's always better to go back to the source of the document.
Oh, and when you say size, do you mean file size or display size ? Display size is different probably because the margins weren't converted properly. Find out the .doc page size and margins and add them to the .rtf.
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