Background: The accuracy of third-trimester ultrasound in detecting large for
gestational age and macrosomic fetuses in diabetic and non-diabetic pregnant
women is unclear in the literature. The aim of the study is to examine the
precision of the 4-parameter Hadlock formula for the prediction of large fetuses
in these two populations. Methods: A systematic review and meta-analysis were
performed, and only studies evaluating the accuracy of third-trimester ultrasound
using the 4-parameter Hadlock formula were included. Data were extracted, and the
meta-analysis was performed using STATA software and Meta-disk 2.0 aiming to
obtain the pooled sensitivity and specificity. Quality assessment of the risk of
bias was performed using the QUADS-2 tool. Results: Nine articles were included
in the final analysis together with 24,693,702 pregnancies screened and 2336 real
large fetuses. The included articles were judged to be at high risk of bias in
more than half of the cases and at doubtful risk in the remaining cases.
Comparison between diabetic and non-diabetic populations was impossible because
the studies considered mixed pregnancies (diabetic and non-diabetic) or only
healthy, so the comparison was made between the latter two groups. The pooled
sensitivity was 0.54 (95% confidence interval (CI): 0.40–0.68), and the pooled
specificity was 0.94 (95% CI: 0.90–0.97). The heterogeneity estimated by the
Bivariate I
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Open Access
Systematic Review
The Accuracy of Third-Trimester Ultrasound in Predicting Large for Gestational Age or Macrosomic Fetuses in Diabetic and Non-Diabetic Pregnant Women: A Systematic Review and Meta-Analysis
Sofia Bussolaro1, Vincenza Cofini2, Stefano Necozione2, Maurizio Guido2,3, Roberto Rulli1, Ilaria Fantasia3,*
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1
Obstetrics & Gynaecology Unit, San Bassiano Hospital, 36061 Bassano Del Grappa, Italy
2
Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
3
Obstetrics & Gynaecology Unit, San Salvatore Hospital, 67100 L'Aquila, Italy
*Correspondence: ilariafantasia@gmail.com (Ilaria Fantasia)
Clin. Exp. Obstet. Gynecol. 2023, 50(7), 144;
https://doi.org/10.31083/j.ceog5007144
Submitted: 8 March 2023 | Revised: 20 March 2023 | Accepted: 20 March 2023 | Published: 13 July 2023
(This article belongs to the Special Issue High Risk Pregnancy and Future Approaches)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract
Keywords
large for gestational age
LGA
macrosomia
gestational diabetes
estimated fetal weight
Figures
Fig. 1.