新生儿足长对早产儿及低出生体重儿的诊断准确性：系统评价和荟萃分析。
Diagnostic accuracy of neonatal foot length to identify preterm and low birthweight infants: a systematic review and meta-analysis.
机构信息
Department of Pediatric Newborn Medicine; Global Advancement of Infants and Mothers (AIM) Lab, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Translational Medicine, GI Drug Discovery Unit, Takeda Pharmaceuticals, Cambridge, Massachusetts, USA.
出版信息
BMJ Glob Health. 2020 Nov;5(11). doi: 10.1136/bmjgh-2020-002976.
INTRODUCTION
Eighty percent of neonatal deaths occur among babies born preterm and/or small for gestational age (SGA). In sub-Saharan Africa and South Asia, approximately 40% of births occur outside of health facilities, and gestational age (GA) and birth weight are commonly unknown. Foot length (FL) has been proposed as a simple, surrogate measurement to identify and triage small babies born in the community. We conducted a systematic review and meta-analysis of the diagnostic accuracy of newborn FL to classify preterm and low birthweight infants.
METHODS
PubMed, EMBASE, Cochrane, Web of Science, POPLINE and WHO Global Health Library databases were searched. Studies of live-born infants that compared FL with GA and/or birth weight were included. Data on diagnostic accuracy were summarised, described, and pooled, as appropriate.
RESULTS
Six hundred and two studies were identified and 41 included. Techniques for measuring FL included use of a firm plastic ruler, callipers, footprint or a measuring board. Twelve studies assessed the diagnostic accuracy of FL to identify preterm births; however, data were not pooled given heterogeneity and low quality of GA. 19 studies used FL to identify low birthweight infants (<2500 g, <2000 g). Among studies in Asia (n=3), FL 7.7 cm had pooled sensitivity and specificity of 87.6% (95% CI 61.1% to 99.0%) and 70.9% (95% CI 23.5% to 95.1%), respectively, to identify <2500 g infants. FL 7.3 cm had 82.1% (95% CI 63.7% to 92.2%) sensitivity and 82.1% (95% CI 59.2% to 90.8%) specificity for identifying <2000 g infants (n=3). In the African studies (n=3), FL 7.9 cm had pooled sensitivity and specificity of 92.0% (95% CI 85.6% to 95.7%) and 71.9% (95% CI 44.5% to 89.1%), respectively, to identify <2500 g neonates.
CONCLUSIONS
FL is a simple proxy measure that can identify babies of low birthweight with high sensitivity, though somewhat lower specificity. Additional research is needed to determine the validity of FL to identify preterm infants, and understand the programmatic impact of screening on healthcare seeking and outcomes.
PROSPERO REGISTRATION NUMBER
CRD42015020499.
简介
80%的新生儿死亡发生在早产儿和/或小于胎龄儿（SGA）中。在撒哈拉以南非洲和南亚，大约 40%的分娩发生在医疗设施之外，胎龄（GA）和出生体重通常未知。足长（FL）已被提议作为一种简单的替代测量方法，用于识别和分类社区中出生的小婴儿。我们对新生儿 FL 分类早产和低出生体重儿的诊断准确性进行了系统评价和荟萃分析。
方法
检索了 PubMed、EMBASE、Cochrane、Web of Science、POPLINE 和世卫组织全球卫生图书馆数据库。纳入了比较 FL 与 GA 和/或出生体重的活产婴儿研究。总结、描述和汇总了诊断准确性数据。
结果
共确定了 602 项研究，其中 41 项符合纳入标准。测量 FL 的技术包括使用坚固的塑料尺、卡尺、脚印或测量板。12 项研究评估了 FL 识别早产的诊断准确性；然而，由于 GA 的异质性和低质量，数据未进行汇总。19 项研究使用 FL 来识别低出生体重儿（<2500g，<2000g）。在亚洲的研究中（n=3），FL 7.7cm 的汇总敏感性和特异性分别为 87.6%（95%CI 61.1%至 99.0%）和 70.9%（95%CI 23.5%至 95.1%），用于识别<2500g 婴儿。FL 7.3cm 对识别<2000g 婴儿的敏感性和特异性分别为 82.1%（95%CI 63.7%至 92.2%）和 82.1%（95%CI 59.2%至 90.8%）（n=3）。在非洲的研究中（n=3），FL 7.9cm 对识别<2500g 新生儿的汇总敏感性和特异性分别为 92.0%（95%CI 85.6%至 95.7%）和 71.9%（95%CI 44.5%至 89.1%）。
结论
FL 是一种简单的替代测量方法，可高度敏感地识别低出生体重婴儿，但特异性稍低。需要进一步研究以确定 FL 识别早产儿的有效性，并了解筛查对医疗保健寻求和结果的计划影响。
PROSPERO 注册号：CRD42015020499。
Zotero 插件