Abstract
Aim
This meta-analysis evaluates the use of cerebroplacental ratio (CPR) in predicting
adverse perinatal outcome.
Methods
An electronic search of PubMed, Embase, Google scholar, Cochrane Library and Up-to-Date
was done using variations of ‘cerebroplacental ratio’ and ‘cerebroumbilical ratio’.
We included studies where CPR was measured and postpartum outcomes were available.
Selected articles were evaluated for quality of study methodology using the Newcastle-Ottawa
Scale, and aggregate statistics for relative risks, odds ratios and 95% confidence
interval were calculated.
Results
Data from 66,392 patients in 47 studies was extracted. There were 25 prospective,
17 retrospective and 5 case-control studies. Data on each obstetric or perinatal outcome
was separately analysed. When analysing the prospective data, it showed abnormal CPR
can predict the need for operative delivery due to foetal distress [RR: 2.52, 95%CI:
2.10–3.02; I2 = 65.78, P < 0.001], low pH [RR: 2.19, 95%CI: 1.01–4.75; I2 = 70.26, P = 0.005] and low Apgar score [RR: 2.05, 95%CI: 1.39–3.03; I2 = 37.15, P = 0.10], foetal or neonatal demise [RR: 2.49, 95%CI: 1.00–6.20], as well
as NICU admission [RR: 2.23, 95%CI: 1.84–2.70; I2 48.53, P = 0.14].The retrospective data showed a statistically significant correlation
in all outcomes but the low pH.
Conclusion
Our meta-analysis shows that CPR can be used to identify foetuses with higher risk
of operative delivery due to foetal distress, low Apgar score, NICU admission, neonatal
morbidity as well as stillbirth and neonatal death rates.
Keywords
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Article info
Publication history
Published online: August 08, 2019
Accepted:
June 28,
2019
Received in revised form:
June 22,
2019
Received:
January 25,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
