title: Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis.
abstract: BACKGROUND
  Fetal macrosomia is associated with an increased risk of adverse maternal and neonatal outcomes.
  
  
  OBJECTIVE
  To compare the accuracy of antenatal two-dimensional (2D) ultrasound, three-dimensional (3D) ultrasound, and magnetic resonance imaging (MRI) in predicting fetal macrosomia at birth.
  
  
  METHODS
  Medline (1966-2013), Embase, the Cochrane Library and Web of Knowledge.
  
  
  METHODS
  Cohort or diagnostic accuracy studies of women with a singleton pregnancy, who had third-trimester imaging to predict macrosomia (>4000 g, >4500 g or >90th or >95th centile).
  
  
  METHODS
  Two reviewers screened studies, performed data extraction and assessed methodological quality. The bivariate model was used to obtain summary sensitivities, specificities and likelihood ratios.
  
  
  RESULTS
  Fifty-eight studies (34 367 pregnant women) were included. Most were poorly reported. Only one study assessed 3D ultrasound volumetry. For predicting birthweight >4000 g or >90th centile, the summary sensitivity for 2D ultrasound (Hadlock) estimated fetal weight (EFW) >90th centile or >4000 g (29 studies) was 0.56 (95% CI 0.49-0.61), 2D ultrasound abdominal circumference (AC) >35 cm (four studies) was 0.80 (95% confidence interval [95% CI] 0.69-0.87) and MRI EFW (three studies) was 0.93 (95% CI 0.76-0.98). The summary specificities were 0.92 (95% CI 0.90-0.94), 0.86 (95% CI 0.74-0.93) and 0.95 (95% CI 0.92-0.97), respectively.
  
  
  CONCLUSIONS
  There is insufficient evidence to conclude that MRI EFW is more sensitive than 2D ultrasound AC (which is more sensitive than 2D EFW); although it was more specific. Further primary research is required before recommending MRI EFW for use in clinical practice.
  
  
  CONCLUSIONS
  Systematic review of antenatal imaging to predict macrosomia. MRI EFW is more sensitive than ultrasound EFW.
authors.affiliation: School of Medicine, the University of Nottingham, Nottingham, UK.
authors.forename: G L
authors.initials: GL
authors.lastname: Malin
authors.affiliation: School of Medicine, the University of Nottingham, Nottingham, UK.|Department of Obstetrics, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Bugg
authors.affiliation: School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Takwoingi
authors.affiliation: School of Medicine, the University of Nottingham, Nottingham, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Thornton
authors.affiliation: School of Medicine, the University of Nottingham, Nottingham, UK.
authors.forename: N W
authors.initials: NW
authors.lastname: Jones
mesh_terms: D000328:Adult; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012016:Reference Values; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal
keywords: Estimated fetal weight; macrosomia; magnetic resonance imaging; pregnancy; three-dimensional ultrasound; two-dimensional ultrasound