SynthesisBMJ paediatrics open2024
Assessing the diagnostic accuracy of postnatal clinical scoring methods and foot length measurement for estimating gestational age and birthweight of newborns in low- and middle-income countries: a systematic review and meta-analysis.
Synthesis in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Higher-volume breastmilk to improve growth among preterm infants in Zambia: A randomized clinical trial.Global pediatrics · 2026Article
- Early detection of cerebral palsy among a high-risk cohort in Bangladesh.BMJ paediatrics open · 2025Article
- Accuracy and utility of newborn foot length screening tools to identify small babies by mothers in Sidama Region, Ethiopia.BMJ paediatrics open · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study aimed to update systematic reviews and meta-analyses on the diagnostic accuracy of postnatal clinical scoring (PCS) methods and foot length (FL) measurement for assessing gestational age (GA) and birth weight in low-income and middle-income countries (LMICs). In addition, the quality of reference standards, including antenatal ultrasound (A-US), last menstrual period (LMP), PCS and newborn weighing scales, was also evaluated.
methodsStudies from LMICs published between January 2000 and February 2024 were searched, using databases such as PubMed, Web of Science, Cochrane Library, CINAHL and Scopus. Studies that compared PCS and/or FL with LMP and/or A-US to estimate GA or used calibrated newborn weighing scales for birthweight estimation were included. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-II tool and evaluated the quality of the reference standards. When sufficient data were available, pooled estimates were calculated using random-effects models.
resultsA total of 50 studies were included. A-US was a reasonable tool for GA assessment if conducted by physicians using fetal biometry and the Hadlock method for GA estimation. LMP was reasonable when women had regular cycles, knew their LMP, were not using contraceptives and LMP data were collected by healthcare providers. When A-US was used as the reference standard, PCS methods estimated GA with a precision of ±2.8 to ±3.2 weeks. FL measurement <7.5 cm showed a pooled sensitivity of 76.2% and specificity of 36.6% for identifying preterm birth. FL measurement ≤7.6 cm had a pooled sensitivity of 78.6% and specificity of 65.7% for identifying low birth weight (LBW). High heterogeneity across studies was observed.
conclusionThis systematic review and meta-analysis highlights significant variability and methodological inconsistencies in using PCS methods and FL measurement for estimating GA and LBW in LMICs. The observed high heterogeneity across studies suggests a cautious interpretation of the results. PROSPERO REGISTRATION NUMBER: CRD42020209455.
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