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

Pay, Aase Serine Devold; Wiik, Johanna; Backe, Bjørn; Jacobsson, Bo; Strandell, Annika; Klovning, Atle
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/298415
Date
2015
Metadata
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  • Institutt for klinisk og molekylær medisin [2016]
  • Publikasjoner fra CRIStin - NTNU [19961]
Original version
BMC Pregnancy and Childbirth 2015, 15(1)   10.1186/s12884-015-0461-z
Abstract
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 < 10th 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).

Keywords: Small-for-gestational-age, Symphysis-fundus height, Pregnancy surveillance, Fetal growth, Fetal growth

restriction
Publisher
BioMed Central
Journal
BMC Pregnancy and Childbirth

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