Minerva ginecologica · 2020
Diagnostic value of sonographic fetal anthropometries and anthropometric formulas to identify macrosomia: a meta-analysis.
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Аннотация
INTRODUCTION: This study evaluated whether sonographic fetal anthropometries and anthropometric formulas can identify macrosomia, with increases in mortality and morbidity rates in infanthood and probably later in life.
EVIDENCE ACQUISITION: Meta-analysis including good-quality studies determined summarized sensitivity, specificity, and positive and negative likelihood ratios (PLR and NLR, respectively) and area under the curve (AUC). PLR and NLR divided informational usability into exclusion and confirmation strategies (10<PLR and NLR<0.1), confirmation strategies only (10<PLR and NLR>0.1), exclusion strategies only (10>PLR and NLR<0.1), or neither exclusion nor confirmation strategies (10>PLR and NLR>0.1). Subgroup and meta-regression analyses were performed.
EVIDENCE SYNTHESIS: Abdominal circumference showed moderately high sensitivity and moderately high specificity (N.=4). However, informational usability classified it as a neither exclusion nor confirmation strategy. Anthropometric formulas showed high specificity (N.=21). However, use of anthropometric formulas showed low sensitivity, and informational usability classified it as a neither exclusion nor confirmation strategy. On the other hand, limiting to Hadlock IV (1985) formula changed this to a confirmation strategy only (N.=7). Hadlock IV (1985) formula versus other formulas may have been a true confounder.
CONCLUSIONS: Abdominal circumference and varying anthropometric formulas are not highly useful for identification of macrosomia. However, Hadlock IV (1985) formula may be useful for secondary screening of macrosomia.
EVIDENCE ACQUISITION: Meta-analysis including good-quality studies determined summarized sensitivity, specificity, and positive and negative likelihood ratios (PLR and NLR, respectively) and area under the curve (AUC). PLR and NLR divided informational usability into exclusion and confirmation strategies (10<PLR and NLR<0.1), confirmation strategies only (10<PLR and NLR>0.1), exclusion strategies only (10>PLR and NLR<0.1), or neither exclusion nor confirmation strategies (10>PLR and NLR>0.1). Subgroup and meta-regression analyses were performed.
EVIDENCE SYNTHESIS: Abdominal circumference showed moderately high sensitivity and moderately high specificity (N.=4). However, informational usability classified it as a neither exclusion nor confirmation strategy. Anthropometric formulas showed high specificity (N.=21). However, use of anthropometric formulas showed low sensitivity, and informational usability classified it as a neither exclusion nor confirmation strategy. On the other hand, limiting to Hadlock IV (1985) formula changed this to a confirmation strategy only (N.=7). Hadlock IV (1985) formula versus other formulas may have been a true confounder.
CONCLUSIONS: Abdominal circumference and varying anthropometric formulas are not highly useful for identification of macrosomia. However, Hadlock IV (1985) formula may be useful for secondary screening of macrosomia.