A seven-study diagnostic meta-analysis involving 900 pregnancies estimated antenatal ultrasound fetal-lung-volume sensitivity at 88%, specificity at 82%, and HSROC AUC at 0.93 for neonatal respiratory distress syndrome. Heterogeneity exceeded 75% and definitions and cut-offs varied, so FLV remains an exploratory adjunct rather than a stand-alone test.
Key findings
- Seven studies (n=900) yielded sensitivity 88% (95% CI 78-94), specificity 82% (70-90), and AUC 0.93, with I² above 75% for both sensitivity and specificity. Infants without RDS had FLV larger by 7.12 cm³ (95% CI 5.90-8.34). Heterogeneity appeared lower in selected subgroups, but study counts were small.
Why this matters globally
If validated, FLV could support delivery planning for high-risk neonates. Diagnostic accuracy is not clinical utility; incremental value beyond gestational age and standard risk factors must improve decisions without excessive false positives.
Thai researcher contribution
Faculty of Medicine researchers at Srinakharinwirot University conducted the systematic review and diagnostic meta-analysis and proposed measurement and reliability standards.
Limitations to consider
Only seven studies and 900 participants from one country were available. Many thresholds were post hoc, RDS definitions varied, confounding was incompletely measured, and reproducibility reporting was limited. FLV depends on gestational age, fetal size, acquisition, and segmentation.