UOG Journal Club: September 2014 Neurodevelopmental outcome in isolated mild fetal ventriculomegaly: systematic review and meta-analysis G. Pagani, B. Thilaganathan and F. Prefumo Volume 44, Issue 3, Date: September 2014, Pages 254-260 Journal Club slides prepared by Dr. Katherine Goetzinger (UOG Editor for Trainees)
UOG Journal Club: Neurodevelopmental outcome in isolated mild fetal ventriculomegaly: systematic review and meta-analysis
Neurodevelopmental outcome in isolated mild fetal ventriculomegaly: systematic review and meta-analysis G. Pagani, B. Thilaganathan and F. Prefumo Volume 44, Issue 3, Date: September 2014, Pages 254-260 http://onlinelibrary.wiley.com/doi/10.1002/uog.13364/abstract
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1. UOG Journal Club: September 2014 Neurodevelopmental outcome
in isolated mild fetal ventriculomegaly: systematic review and
meta-analysis G. Pagani, B. Thilaganathan and F. Prefumo Volume 44,
Issue 3, Date: September 2014, Pages 254-260 Journal Club slides
prepared by Dr. Katherine Goetzinger (UOG Editor for Trainees)
2. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Mild fetal ventriculomegaly occurs in 0.7% of
pregnancies and is diagnosed when the atrial width of the lateral
cerebral ventricle measures between 10 and 15mm. This diagnosis is
variably associated with chromosomal and structural malformations
as well as fetal infection. Ventriculomegaly is defined as isolated
if no ultrasound evidence of associated malformations or markers of
aneuploidy are observed at the time of presentation. Even when
isolated, mild ventriculomegaly has been linked to abnormal
neurodevelopment; however, this association varies widely in the
literature with estimates ranging from 0% to 40%.
3. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Objective To perform a systematic review and
meta-analysis of the current literature to: 1) assess the
prevalence of neurodevelopmental delay in cases of isolated mild
ventriculomegaly 2) assess the false-negative rate of prenatal
imaging for the diagnosis of associated abnormalities in patients
referred for isolated mild ventriculomegaly
4. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Methodology Systematic Review & Meta-Analysis
Search Strategy: MEDLINE, EMBASE, Scopus, Cochrane Library
Inclusion Criteria: Observational studies evaluating
neurodevelopmental delay in cases of isolated mild ventriculomegaly
Exclusion Criteria: Fetal karyotype not available, bilateral
ventriculomegaly reported as an exclusion criterion, associated
abnormality (chromosomal or structural) observed before or after
birth, non-English language publication
5. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Methodology Systematic Review & Meta-Analysis
Outcomes: Incidence of neurodevelopmental delay False-negative rate
of prenatal imaging: prevalence of new postnatal findings in the
group of cases labeled as isolated prenatally Analysis: Forest
plots: random effects models Between-study heterogeneity: Higgins
I2 Publication bias: funnel plots and Begg and Mazumdars rank
correlation test Rosenthals failsafe N test and cumulative
meta-analysis
6. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Results Potentially appropriate studies identified
from search (n=961) Citations retrieved for detailed evaluation of
manuscript (n=57) Studies included in systematic review (n=20)
Citations excluded based on title or abstract (n=904) Studies
excluded (n=37) After exclusions, there were a total of 652 cases
of mild isolated ventriculomegaly, of which 67 cases had
neurodevelopmental delay
7. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Results Of 1213 fetuses with a prenatal diagnosis of
isolated mild ventriculomegaly, 57 (4.7%) had an abnormal karyotype
Of those with a normal karyotype, associated abnormalities were
found in 387 (33.5%), of which 355 (91.7%) were diagnosed before
birth Postnatal imaging (ultrasound or MRI) was performed in 531
(43.8%) cases and identified 34 additional associated
malformations
8. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Results The false-negative rate of prenatal imaging
in the detection of associated structural malformations was: 7.4%
(95% CI 3.1-11.8%) I2 random = 60.1%
9. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Results The incidence of neurodevelopmental delay in
the 652 isolated cases of ventriculomegaly was: 7.9% (95% CI,
4.7-11.1%) I2 random = 55.9%
10. Neurodevelopmental outcome in isolated mild fetal
ventriculomegaly: systematic review and meta-analysis Pagani et
al., UOG 2014 Results Significant publication bias was identified
(p