Adverse neonatal outcomes in small‐for‐gestational age twins identified using twin <i>vs</i> singleton growth charts: systematic review and meta‐analysis
Notice bibliographique
Résumé
OBJECTIVE: To evaluate the use of twin vs singleton growth charts for detecting small-for-gestational-age (SGA) twins at risk of adverse neonatal outcomes. METHODS: MEDLINE, EMBASE, CINAHL, Cochrane and Scopus databases were searched electronically from inception to May 2024. The primary outcome of this meta-analysis was the risk of composite adverse neonatal outcome in SGA fetuses in a twin pregnancy diagnosed using twin or singleton charts. The secondary outcomes included: neonatal intensive care unit (NICU) admission, oxygen supplementation or continuous positive airway pressure, mechanical ventilation, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, neonatal sepsis and neonatal mortality. Prospective and retrospective studies on neonatal outcomes of monochorionic or diamniotic twins diagnosed with SGA using both singleton and twin charts based on estimated fetal weight or birth weight were considered suitable for inclusion. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. Random-effects head-to-head meta-analyses were used to analyze the data. RESULTS: Six studies were included in the systematic review and five studies, including 10 554 twin pregnancies, were included in the meta-analysis. The risk of composite adverse neonatal outcome (OR, 3.11 (95% CI, 1.83-5.26)) and that of most secondary outcomes was significantly higher in SGA fetuses diagnosed using twin charts compared with those diagnosed using singleton charts. Conversely, the risk of composite adverse neonatal outcome (OR, 1.22 (95% CI, 0.73-2.04)) and most secondary outcomes was similar when comparing SGA fetuses diagnosed using singleton charts vs non-SGA fetuses diagnosed using twin charts, except for the risk of NICU admission, which was significantly higher in SGA fetuses diagnosed using singleton charts. When comparing non-SGA fetuses diagnosed using twin charts vs non-SGA fetuses diagnosed using singleton charts, the risk of composite adverse neonatal outcome was significantly lower when using twin charts (OR, 0.90 (95% CI, 0.83-0.97)). Finally, when comparing SGA vs non-SGA fetuses diagnosed using singleton charts, there was no significant difference for the primary or secondary outcomes, except for a higher risk of NICU admission in the SGA group (OR, 1.54 (95% CI, 1.11-2.12)). Twin charts had lower sensitivity than singleton charts in predicting adverse neonatal outcome (14% (95% CI, 7-26%) vs 32% (95% CI, 24-41%)), but higher specificity (95% (95% CI, 86-98%) vs 71% (95% CI, 63-77%)). CONCLUSIONS: Twin charts increase the specificity but reduce the sensitivity for the detection of SGA compared with singleton charts. Nevertheless, twin charts detect cases at higher risk of adverse neonatal outcome, which may be the cases that require intervention. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,057 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,008 | 0,001 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».