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Accuracy of on‐site tests to detect anemia during prenatal care
Author(s) -
Sobhy Soha,
Rogozinska Ewelina,
Khan Khalid S.
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12289
Subject(s) - medicine , prenatal care , anemia , obstetrics , environmental health , population
Background Anemia is a substantial contributor to poor pregnancy outcomes in low‐ and middle‐income countries. Access to laboratory facilities is limited; therefore, on‐site testing warrants attention. Objectives To determine the accuracy of on‐site tests to detect anemia in pregnancy. Search strategy MEDLINE , Embase, Scopus, CINAHL , and Web of Science were searched from inception until March 2016, with no language restrictions, using the terms “pregnancy,” “an(a)emia,” and “h(a)emoglobin.” Selection criteria Studies that evaluated the diagnostic accuracy of on‐site hemoglobin tests versus laboratory‐based reference tests during pregnancy were included. Data collection and analysis Study characteristics and true positive, true negative, false positive, and false negative rates were extracted. Sensitivity, specificity, likelihood ratios, and post‐test probabilities were calculated. Anemia was defined as a hemoglobin level of less than 110 g/L. Main results Ten studies (4239 participants) were assessed. Copper sulfate provided 97% sensitivity (95% confidence interval [ CI ] 88%–100%) and 71% specificity (95% CI 55%–85%); the Sahli method provided 86% sensitivity (95% CI 75%–94%) and 83% specificity (95% CI 68%–93%); and HemoCue provided 85% sensitivity (95% CI 79%–90%) and 80% specificity (95% CI 76%–83%). Conclusions Some on‐site tests are accurate and should be made widely available to improve detection of anemia in pregnancy.