Ultrasound fetal anthropometry to identify large-for-gestational-age: a meta-analysis.

Abstract

Large-for-gestational-age (LGA) has been suggested to show high rates of mortality and morbidity in pregnant women and their neonates. This study was based on data from 2015 or later to determine whether ultrasound fetal anthropometry is helpful for identifying LGA. Sensitivity, specificity, positive and negative likelihood ratios (LRs), and diagnostic odds ratio (DOR) of studies published in English were summarized using bivariate diagnostic meta-analysis. Study quality was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies tool. Deeks' funnel plot asymmetry test was assessed to identify publication bias. The findings of abdominal circumference were based on a single article. Despite high specificity (0.92), anthropometric formulas showed moderate sensitivity (0.71) and DOR (26) and were categorized as providing "neither exclusion (positive LR<10) nor confirmation (negative LR>0.1)" strategy based on 28 good-quality studies in five articles. However, they were more promising than previous meta-analytic findings not limited to 2015 or later. No publication bias was identified with respect to assessment of anthropometric formulas (P=0.286). Current ultrasound fetal anthropometry is not strongly helpful, but the values of anthropometric formulas provided by future ultrasound are expected especially as the secondary screening of LGA.