Diagnostic Value of Maternal Anthropometric Measurements for Predicting Low Birth Weight in Developing Countries: A Meta-Analysis

发展中国家孕妇人体测量指标预测低出生体重的诊断价值：一个荟萃分析

Eita Goto

《Asia Pacific Journal of Clinical Nutrition》 24卷2期 (2015/06) Pp. 260-272

https://doi.org/10.6133/apjcn.2015.24.2.05

摘要

目的：发展中国家在家出生的婴儿往往没有进行称重。因此，尤其是在出生前检测低出生体重的简单、可靠和廉价的方法是很有用的。本研究为评估产妇人体测量指标预测婴儿低出生体重的诊断价值。方法：采用二元诊断荟萃分析，以构建多层次综合的受试者工作特征曲线。所有英语报道的看上去健康的孕妇并提供了构建2×2表（即真阳性、假阳性、假阴性和真阴性值）必要资料的研究均纳入本荟萃分析。在PubMed等10个数据库中进行检索确定这些研究。结果：检索到了包括来自非洲、亚洲、欧洲、拉丁美洲、中东和大洋洲的309,419名妇女及其新生儿的大量研究，其提供的可推广的研究结果包括母亲的身高、体重、上臂围、体质指数和怀孕期间体重增加（n分别为85、80、23、51和16）。然而，0.46（95%CI=0.35-0.56）到0.63（95%CI=0.54-0.71）的灵敏度，0.55（95%CI=0.42-0.67）到0.71（95%CI=0.61-0.80）的特异度和2（95%CI=2-2）到4（95%CI=3-5）的诊断比值比对初步筛查是不够高的。由于样本有限（1篇文章），腹围数据无法推广。结论：产妇人体测量指标不适合预测低出生体重。

關鍵字

人体测量学 ； 低出生体重 ； 荟萃分析 ； 孕妇 ； 灵敏度和特异度

並列摘要

Objective: Weighing scales are often lacking at home birth in developing countries. Therefore, simple, reliable, and inexpensive methods for detecting low birth weight especially before birth would be useful. This study was performed to evaluate the diagnostic value of maternal anthropometric measurements for predicting low birth weight. Methods: Bivariate diagnostic meta-analysis was conducted to construct hierarchical summary receiver operating characteristic curves. All English language studies included in the meta-analysis enrolled apparently healthy pregnant women and provided the data necessary to construct two-by-two tables (i.e., true positive, false positive, false negative, and true negative values). Ten data bases, including PubMed, were searched to identify these studies. Results: A sufficient number of studies involving 309,419 women paired with their newborns in Africa, Asia, Europe, Latin America, the Middle East, and Oceania, included data on maternal height, weight, arm circumference, body mass index, and weight gain during pregnancy (n=85, 80, 23, 51, and 16, respectively) to provide generalizable findings. However, sensitivity of 0.46 (95% confidence interval (CI)=0.35-0.56) to 0.63 (95% CI=0.54-0.71), specificity of 0.55 (95% CI=0.42-0.67) to 0.71 (95% CI=0.61-0.80), and diagnostic odds ratios of 2 (95% CI=2-2) to 4 (95% CI=3-5) were not sufficiently high for primary screening. The generalizability of abdominal circumference data could not be guaranteed due to the limited sample (one article). Conclusions: Maternal anthropometric measurements are unsuitable for predicting low birth weight.

並列關鍵字

anthropometry ； low birth weight ； meta-analysis ； pregnant women ； sensitivity and specificity