Sobhy Soha, Rogozinska Ewelina, Khan Khalid S
Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Multidisciplinary Evidence Synthesis Hub, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Int J Gynaecol Obstet. 2017 Nov;139(2):130-136. doi: 10.1002/ijgo.12289. Epub 2017 Aug 19.
Anemia is a substantial contributor to poor pregnancy outcomes in low- and middle-income countries. Access to laboratory facilities is limited; therefore, on-site testing warrants attention.
To determine the accuracy of on-site tests to detect anemia in pregnancy.
MEDLINE, Embase, Scopus, CINAHL, and Web of Science were searched from inception until March 2016, with no language restrictions, using the terms "pregnancy," "an(a)emia," and "h(a)emoglobin."
Studies that evaluated the diagnostic accuracy of on-site hemoglobin tests versus laboratory-based reference tests during pregnancy were included.
Study characteristics and true positive, true negative, false positive, and false negative rates were extracted. Sensitivity, specificity, likelihood ratios, and post-test probabilities were calculated. Anemia was defined as a hemoglobin level of less than 110 g/L.
Ten studies (4239 participants) were assessed. Copper sulfate provided 97% sensitivity (95% confidence interval [CI] 88%-100%) and 71% specificity (95% CI 55%-85%); the Sahli method provided 86% sensitivity (95% CI 75%-94%) and 83% specificity (95% CI 68%-93%); and HemoCue provided 85% sensitivity (95% CI 79%-90%) and 80% specificity (95% CI 76%-83%).
Some on-site tests are accurate and should be made widely available to improve detection of anemia in pregnancy.
在低收入和中等收入国家，贫血是导致不良妊娠结局的一个重要因素。获得实验室检测设施的机会有限；因此，现场检测值得关注。
确定现场检测在妊娠期间检测贫血的准确性。
检索了MEDLINE、Embase、Scopus、CINAHL和Web of Science数据库，检索时间从建库至2016年3月，无语言限制，检索词为“妊娠”“贫血”和“血红蛋白”。
纳入评估妊娠期间现场血红蛋白检测与基于实验室的参考检测的诊断准确性的研究。
提取研究特征以及真阳性、真阴性、假阳性和假阴性率。计算敏感性、特异性、似然比和验后概率。贫血定义为血红蛋白水平低于110g/L。
评估了10项研究（4239名参与者）。硫酸铜检测的敏感性为97%（95%置信区间[CI]88%-100%），特异性为71%（95%CI 55%-85%）；沙利氏法检测的敏感性为86%（95%CI 75%-94%），特异性为83%（95%CI 68%-93%）；血红蛋白比色计检测的敏感性为85%（95%CI 79%-90%），特异性为80%（95%CI 76%-83%）。
一些现场检测方法准确，应广泛应用以改善妊娠期间贫血的检测。
