Symphysis-fundus height measurement to predict small-for-gestational-age status at birth: a systematic review

BMC Pregnancy and Childbirth

Atle Klovning²  Annika Strandell⁴  Bo Jacobsson³  Bjørn Backe⁵  Johanna Wiik⁴  Aase Serine D Pay¹ 

[1] Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway;Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway;Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway;Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden;Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Technology and Science, Trondheim University Hospital, Trondheim, Norway

关键词: Fetal growth restriction;    Fetal growth;    Pregnancy surveillance;    Symphysis-fundus height;    Small-for-gestational-age;   

Others  :  1125387
DOI  :  10.1186/s12884-015-0461-z

 received in 2014-11-12, accepted in 2015-01-30,  发布年份 2015

【 摘 要 】

Background

Fetal growth restriction is among the most common and complex problems in modern obstetrics. Symphysis-fundus (SF) height measurement is a non-invasive test that may help determine which women are at risk. This study is a systematic review of the literature on the accuracy of SF height measurement for the prediction of small-for-gestational-age (SGA) status at birth in unselected and low-risk pregnancies.

Methods

The Medline, Embase, Cinahl, SweMed, and Cochrane Library databases were searched with no limitation on publication date (through September 2014), which returned 722 citations. Two reviewers then developed a short list of 51 publications of possible relevance and assessed them using the following inclusion criteria: cohort study of test accuracy performed in a routine prenatal care setting; SF height measurement for all participants; classification of SGA, defined as birth weight (BW) < 10th, 5th, or 3rd percentile or ≥ one or two standard deviations below the mean; study conducted in Northern, Western, or Central Europe; USA; Canada; Australia; or New Zealand; and sufficient data for 2 × 2 table construction. Quality of the included studies was assessed in duplicate using criteria suggested by the Cochrane Collaboration. Review Manager 5.3 software was used to analyze the data, including plotting of summary receiver operating curve spaces.

Results

Eight studies were included in the final dataset and seven were included in summary analyses. The sensitivity of SF height measurement for SGA (BW < 10^th percentile) prediction ranged from 0.27 to 0.76 and specificity ranged from 0.79 to 0.92. Positive and negative likelihood ratios ranged from 1.91 to 9.09 and from 0.29 to 0.83, respectively.

Conclusions

SF height can serve as a clinical indicator along with other clinical findings, information about medical conditions, and previous obstetric history. However, SF height has high false-negative rates for SGA. Clinicians must understand the limitations of this test.

The protocol has been registered in the international prospective register of systematic reviews, PROSPERO (Registration No. CRD42014008928, http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42014008928 webcite).

【 授权许可】

   
2015 Pay et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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