Dataset Information

Ultrasound as a primary screening tool for detecting low birthweight newborns: A meta-analysis.

ABSTRACT:

Background

As low birthweight (i.e., birthweight?MethodsThe primary outcomes included sensitivity, specificity, and positive and negative likelihood ratios of ultrasound detection of low birthweight newborns. Ten databases, including PubMed, were searched. All English language studies that provided true- and false-positive and true- and false-negative results regarding the pre-delivery ultrasound detection of low birthweight newborns were eligible for inclusion in the analysis. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies. Bivariate diagnostic meta-analysis was performed and hierarchical summary receiver operating characteristic curves were constructed.

Results

Studies of relatively good quality were included in the analysis to evaluate crown-rump length (n?=?12); femur length (n?=?5); formulas of Campbell, Hadlock, and Shepard (n?=?9); and uterine artery blood flow (n?=?7). All showed low sensitivity (=0.24-0.58) regardless of specificity (=0.60-0.96). The formulas of Campbell, Hadlock, and Shepard were usable for a confirmation strategy only (positive and negative likelihood ratios?=?14.8 and 0.44, respectively), but crown-rump or femur length, and uterine artery blood flow were not usable for an exclusion or confirmation strategy (positive and negative likelihood ratios?=?1.4-2.8 and 0.71-0.85, respectively).

Conclusions

Primary screening does not have to confirm low birthweight, but should almost always categorize low birthweight as a positive result and exclude normal birthweight. Therefore, ultrasound is not suitable as a primary screening tool to detect low birthweight newborns.

SUBMITTER: Goto E

PROVIDER: S-EPMC5008608 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Ultrasound as a primary screening tool for detecting low birthweight newborns: A meta-analysis.

Goto Eita E

Medicine 20160801 35

<h4>Background</h4>As low birthweight (i.e., birthweight < 2500 g) is a major determinant of neonatal mortality and morbidity, the pre-delivery detection of low birthweight is clinically advantageous. This study was performed to determine whether ultrasound is suitable for use in primary screening to detect low birthweight newborns.<h4>Methods</h4>The primary outcomes included sensitivity, specificity, and positive and negative likelihood ratios of ultrasound detection of low birthweight newborn ...[more]

PMID: 27583924

Similar Datasets

Project description:BACKGROUND:Phenylketonuria (PKU), which is characterized by a deficiency of phenylalanine hydroxylase activity, is an autosomal recessive disorder of phenylalanine (Phe) metabolism. Newborn screening is the main population-based public health screening program that allows successful identification and treatment of PKU with low-Phe diet. The aim of this study was to evaluate the epidemiology of PKU screening in Iranian newborns. METHODS:The present study was designed based on MOOSE protocol and reporting was done in accordance with the PRISMA guidelines. The protocol of this systematic review was published in PROSPERO before it was performed (CRD42020162626). A comprehensive search was done in 10/10/2019 to find related literature on international online databases Web of Science, Scopus, EMBASE, Science Direct, PubMed/Medline, EBSCO, CINAHL, Cochrane Library, national online databases and the Google Scholar search engine. Heterogeneity among studies was assessed by I2 index and Q test. All meta-analyses were performed using Comprehensive Meta-Analysis Software ver. 2. P?<?0.05 was considered significant. RESULT:Finally, 18 studies with 3,339,327 Iranian neonates were included. The prevalence of suspected hyperphenylalaninemia (HPA) was estimated to be 45.6/100,000 (95% CI: 23.9-87.1). The prevalence of suspected HPA in girls and boys infants in Iran was estimated to be 38.0/100,000 (95% CI: 15.1-95.5) and 43.3/100,000 (95% CI: 16.2-116.2), respectively. The prevalence of PKU was estimated to be 16.5/100,000 (95% CI: 12.9-21.2). The prevalence of PKU in girls and boys infants was estimated to be 13.3/100,000 (95% CI: 7.5-15.8) and 10.9/100,000 (95% CI: 7.5-15.8), respectively. The prevalence of mild to moderate HPA was estimated 9.7/100,000 (95% CI: 5.1-18.4) and the prevalence of classical PKU was estimated 4.4/100,000 (95% CI: 2.5-7.8). Sensitivity analysis for all meta-analysis with the omission of one study showed that overall estimation is still robust. CONCLUSION:The results of this meta-analysis showed that PKU is prevalent in Iranian neonates. It should be considered that for PKU there is a highly effective dietary treatment which can prevent the clinical symptoms of PKU if initiated early after detection by newborn screening.

Project description:INTRODUCTION:In sub-Saharan African countries, low birthweight (LBW) accounts for three-quarters of under-five mortality and morbidity. However, there is no systematic evidence of sex differences in LBW survival risk. The aim of this protocol is to outline the methodological process of a systematic review that will gather qualitative and quantitative data on sex differences in survival among LBW newborns and infants in sub-Saharan Africa. METHODS:This protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. We will conduct a systematic review to retrieve all qualitative and quantitative studies. Electronic search strategies are being finalised on 24 February 2020 for Ovid Medline and EMBASE, and on 28 February 2020 for CINAHL, Scopus and Global Health in collaboration with a Health Sciences librarian. The primary outcome of interest is indicating sex differences in survival among LBW newborns and infants. Secondary outcomes are sex-disaggregated differences in morbidity among LBW newborns and infants. Screening, data extraction and assessments of risk of bias will be performed independently. Narrative synthesis and a meta-analysis will be conducted with studies that are compatible based on population and outcome. The systematic review is focused on the analysis of secondary data and does not require ethics approval. ETHICS AND DISSEMINATION:As it will be a systematic review, without human participants' involvement, there will be no requirement for ethical approval. The systematic review will present key evidence of sex-disaggregated differences in mortality and morbidity among LBW newborns and infants in sub-Saharan Africa. Programme managers, policy-makers and researchers can use the findings to evaluate LBW health outcomes in different sexes. The final manuscript will be disseminated through a peer-reviewed journal and scientific conferences. PROSPERO REGISTRATION NUMBER:CRD42020163470.

Project description:Study questionAre intrauterine conditions, reflected in birthweight, associated with the development of polycystic ovary syndrome (PCOS)?Summary answerOur study indicates that a low birthweight as a summary measure of intrauterine environment may be associated with PCOS when diagnosed according to the Rotterdam criteria.What is already knownThe etiology of PCOS is still largely unknown. Besides subfertility, women diagnosed with PCOS have an increased risk of chronic health issues. PCOS has been linked to adverse prenatal conditions, including a low birthweight.Study design size durationA systematic search of the literature and meta-analysis of pooled data was undertaken, according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) and meta-analysis of observational studies in epidemiology (MOOSE) guidelines.Participants/materials setting methodThe following online databases were systematically searched: PubMed, EMBASE, CINAHL (via EBSCO) and Cochrane library up to 10 June 2017, with no language or date restrictions.Main results and the role of chanceA total of 1484 studies were identified of which 16 met the inclusion criteria and 14 provided data for meta-analysis. The exposure variable birthweight was either analyzed as a categorical variable using the birthweight categories <2.5, 2.5-4 and >4 kg, or as a continuous variable. We composed a birthweight category consisting of birthweights <2.5 kg plus birthweights >4 kg, reflecting extreme birthweights. In a subset analysis, we investigated the association between a low birthweight and PCOS while differentiating between Rotterdam and NIH criteria. When diagnosed according to the Rotterdam criteria, women born with birthweights lower than 2.5 kg had an odds ratio [95% CI] of 1.76 [1.14,2.70] for PCOS compared to women born with birthweights higher than 2.5 kg. For the latter analysis, we were able include 1252 women (I 2 = 16%). There was no significant effect of birthweight on PCOS when diagnosed according to NIH criteria.Limitations reasons for cautionThe funnel plot of the studies providing data for the meta-analysis and the subset analysis indicates a publication bias.Wider implications of the findingsA low birthweight could be a risk factor for PCOS when diagnosed according to the Rotterdam criteria.Study funding/competing interestsNone.Trial registration numberThe protocol of this study was registered at PROSPERO under registration number CRD42016048972.

Project description:BackgroundThis study aimed to update systematic reviews and meta-analyses on the diagnostic accuracy of postnatal clinical scoring (PCS) methods and foot length (FL) measurement for assessing gestational age (GA) and birth weight in low-income and middle-income countries (LMICs). In addition, the quality of reference standards, including antenatal ultrasound (A-US), last menstrual period (LMP), PCS and newborn weighing scales, was also evaluated.MethodsStudies from LMICs published between January 2000 and February 2024 were searched, using databases such as PubMed, Web of Science, Cochrane Library, CINAHL and Scopus. Studies that compared PCS and/or FL with LMP and/or A-US to estimate GA or used calibrated newborn weighing scales for birthweight estimation were included. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-II tool and evaluated the quality of the reference standards. When sufficient data were available, pooled estimates were calculated using random-effects models.ResultsA total of 50 studies were included. A-US was a reasonable tool for GA assessment if conducted by physicians using fetal biometry and the Hadlock method for GA estimation. LMP was reasonable when women had regular cycles, knew their LMP, were not using contraceptives and LMP data were collected by healthcare providers. When A-US was used as the reference standard, PCS methods estimated GA with a precision of ±2.8 to ±3.2 weeks. FL measurement <7.5 cm showed a pooled sensitivity of 76.2% and specificity of 36.6% for identifying preterm birth. FL measurement ≤7.6 cm had a pooled sensitivity of 78.6% and specificity of 65.7% for identifying low birth weight (LBW). High heterogeneity across studies was observed.ConclusionThis systematic review and meta-analysis highlights significant variability and methodological inconsistencies in using PCS methods and FL measurement for estimating GA and LBW in LMICs. The observed high heterogeneity across studies suggests a cautious interpretation of the results.Prospero registration numberCRD42020209455.

Project description:BACKGROUND:Most newborn deaths occur among those of low birthweight (LBWt), due to prematurity &/or impaired fetal growth. Simple practices can substantially mitigate this risk. In low-income country settings where many births occur at home, strategies are needed that empower mothers to determine if their babies are at higher risk and, if so, to take measures to reduce risk. Earlier studies suggest that foot-length may be a good proxy for birthweight. An earlier Nepal study found a 6.9?cm cut-off performed relatively well, differentiating normal from low birthweight. METHODS:Community-based, cluster-randomized controlled trial. OBJECTIVE:to determine whether family-administered screening, associated with targeted messages improves care practices known to mitigate LBWt-associated risks. PARTICIPANTS:women participating in a parent trial in rural Nepal, recruited late in pregnancy. Women were given a 6.9?cm card to assess whether the baby's foot is small; if so, to call a number on the card for advice. Follow-up visits were made over the 2?weeks following the birth, assessing for 2 behavioral outcomes: reported skin-to-skin thermal care, and care-seeking outside the home; assessed restricting to low birthweight (using 2 cutoffs: 2500?g and 2000?g). Randomization: 17 clusters intervention, 17 control. The study also documented performance along the presumed causal chain from intervention through behavioral impact. RESULTS:2022 intervention, 2432 control. Intervention arm: 519 had birthweight <?2500?g (vs. 663 among controls), of which 503 were available for analysis (vs. 649 among controls). No significant difference found on care-seeking; for those <?2500?g RR 1.13 (95%CI: 0.97-1.131). A higher proportion of those in the intervention arm reported skin-to-skin thermal care than among controls; for those <?2500?g RR 2.50 (95%CI: 2.01-3.1). However, process measures suggest this apparent effect cannot be attributed to the intervention; the card performed poorly as a proxy for LBWt, misclassifying 84.5% of those <?2000 as normal weight. CONCLUSIONS:Although the trial found an apparent effect on one of the behavioral outcomes, this cannot be attributed to the intervention; most likely it was a result of pure chance. Other approaches are needed for identifying small, at-risk babies in such settings, and targeting them for appropriate care messaging. TRIAL REGISTRATION:ClinicalTrials.gov NCT02802332 , registered 6/16/2016.

Dataset Information

Ultrasound as a primary screening tool for detecting low birthweight newborns: A meta-analysis.

Background

Results

Conclusions

Publications

Ultrasound as a primary screening tool for detecting low birthweight newborns: A meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets