Ultrasound prediction of fetal macrosomia in pregnancies complicated by diabetes mellitus: a systematic review and meta-analysis.

birthweight gestational diabetes high risk pregnancies macrosomia prenatal diagnosis prenatal ultrasound

Journal

Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031

Informations de publication

Date de publication:
12 Jun 2024
Historique:
received: 27 03 2024
accepted: 02 05 2024
medline: 11 6 2024
pubmed: 11 6 2024
entrez: 11 6 2024
Statut: aheadofprint

Résumé

To report the diagnostic accuracy of ultrasound in identifying fetuses with macrosomia in pregnancies complicated by gestational or pregestational diabetes. Medline, Embase and Cochrane databases were searched. Inclusion criteria were singleton pregnancies complicated by diabetes undergoing third-trimester ultrasound evaluation. The index test was represented by ultrasound estimation of fetal macrosomia (estimated fetal weight EFW or abdominal circumference AC >90th or 95th percentile). Subgroup analyses were also performed. Sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio were computed using the hierarchical summary receiver-operating characteristics model. Twenty studies were included in the systematic review including 8,530 pregnancies complicated by diabetes. Ultrasound showed an overall moderate accuracy in identifying fetuses with macrosomia with a sensitivity of 71.2 % (95 % CI 63.1-78.2), a specificity of 88.6 % (95 % CI 83.9-92.0). The interval between ultrasound and birth of two weeks showed the highest sensitivity and specificity (71.6 %, 95 % CI 47.9-87.3 and 91.7, 95 % CI 86.2-95.5). EFW sensitivity and specificity were 76.6 % (95 % CI 70.1-82.3) and 82.9 % (95 % CI 80.9-84.8), while AC 84.8 % (95 % CI 78.2-90.0) and 73.7 % (95 % CI 71.0-76.4). Ultrasound demonstrates an overall good diagnostic accuracy in detecting fetal macrosomia in pregnancies with diabetes.

Identifiants

pubmed: 38860644
pii: jpm-2024-0121
doi: 10.1515/jpm-2024-0121
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 Walter de Gruyter GmbH, Berlin/Boston.

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Auteurs

Chiara Panunzi (C)

Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Federica Cardinali (F)

Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Asma Khalil (A)

Fetal Medicine Unit, Saint George's Hospital, London, UK.
Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
Fetal Medicine Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK.

Hiba J Mustafa (HJ)

Division of Maternal-Fetal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
The Fetal Center at Riley Children's Hospital, Indianapolis, IN, USA.

Arsenio Spinillo (A)

Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Giuseppe Rizzo (G)

Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Rome, Italy.

Maria Elena Flacco (ME)

Department of Environmental and Preventive sciences, University of Ferrara, Ferrara, Italy.

Giuseppe Maruotti (G)

Department of Obstetrics and Gynecology, University of Naples, Naples, Italy.

Francesco D'Antonio (F)

Center for Fetal Care and High-risk Pregnancy, Department of Obstetrics and Gynecology, University of Chieti Via Dei Vestini, Chieti, Italy.

Classifications MeSH