Perinatal Outcomes After Selective Third-Trimester Ultrasound Screening for Small-for-Gestational Age
Author Information
Author(s): Winsloe C., Elhindi J., Vieira M. C., Relph S., Arcus C. G., Coxon K., Briley A., Johnson M., Page L. M., Shennan A., Marlow N., Lees C., Lawlor D. A., Khalil A., Sandall J., Copas A., Pasupathy D.
Primary Institution: Department of Women and Children's Health, King's College London
Hypothesis
What are the perinatal outcomes associated with false-negative and false-positive diagnoses of small-for-gestational age (SGA) in selective third-trimester ultrasound screening?
Conclusion
Both false-negative and false-positive results in selective third-trimester ultrasound screening for SGA are linked to a higher risk of stillbirth compared to true-positive and true-negative results.
Supporting Evidence
- Fetuses with a false-negative SGA screening result had a higher risk of stillbirth compared to true positives.
- False-positive results were associated with a lower birth weight percentile and increased risk of stillbirth.
- Only 22% of SGA neonates were correctly detected before birth.
- False-negative cases were born later and had less severe SGA compared to true positives.
Takeaway
This study found that missing a diagnosis of small babies can lead to more stillbirths, and wrongly identifying a baby as small can also be risky, so better detection methods are needed.
Methodology
This was a prospective cohort study nested within the DESiGN trial, analyzing pregnancies without antenatally detected fetal anomalies and comparing outcomes based on SGA screening results.
Potential Biases
Potential biases include the influence of different ultrasound standards and the inability to determine how antenatal diagnoses influenced clinical decision-making.
Limitations
The study's SGA detection was poor, and the influence of different standards on SGA detection was not fully explored.
Participant Demographics
The study included a diverse cohort with a significant proportion of minority ethnic groups.
Statistical Information
Confidence Interval
1.07–1.31 for false negatives and 1.88–2.68 for false positives.
Digital Object Identifier (DOI)
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