The Incremental Yield of CMA Over Karyotype in Fetal Growth Restriction—A Systematic Review and Meta-Analysis

Abstract

The main objective of our study was to conduct a systematic literature review and a meta-analysis to evaluate the incremental yield of chromosomal microarray analysis compared with karyotyping in cases of fetal growth restriction. Our review was designed according to the PRISMA guidelines. It included all observational studies that reported the results of CMA testing in fetuses diagnosed with growth restriction without additional findings (isolated FGR), with structural abnormalities (malformed FGR) and with the presence of additional findings that would not qualify as structural abnormalities (nonmalformed FGR). The study included 22 studies with a total of 2275 cases of affected fetuses that met the inclusion criteria for analysis. Combined data from these studies revealed an overall 3% incremental yield of CMA over karyotyping (95% CI 2%–5%) in isolated cases, an overall 4% incremental yield of CMA over karyotyping (95% CI 3%–5%) in nonmalformed FGR cases and an overall 10% incremental yield (95% CI –13%) in malformed FGR cases. Our findings may be useful in clinical practice to guide management options and the counseling of the couples to individualize patient care and facilitate clinicians when they come across such a common clinical entity.