Diagnostic accuracy of lung ultrasound score for bronchopulmonary dysplasia in preterm neonates: a systematic review and meta-analysis
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background Bronchopulmonary dysplasia (BPD) remains common among preterm infants, yet diagnostic criteria rely on post-hoc oxygen requirements and radiography. Semiquantitative lung ultrasound (LUS) scoring offers a radiation-free, bedside alternative. We sought to determine the time-dependent diagnostic accuracy of LUS scores for BPD in preterm neonates. Methods We performed a systematic review and meta-analysis of studies reporting LUS scores in preterm neonates (born at <37 gestational weeks) with BPD. We searched five databases through June 2025. We stratified data into four postnatal age timepoints (days 1–3, 7, 14, and 21) and pooled them using bivariate random-effects models to estimate sensitivity, specificity, likelihood ratios, diagnostic odds ratios, and area under the hierarchical summary receiver-operating characteristic (HSROC) curve. Results We included data from 22 studies ( n = 2,038 infants) in our analyses. Within days 1–3 (10 studies; n = 1,326), LUS scores yielded sensitivity of 0.75 (95% CI, 0.62–0.85), specificity of 0.74 (0.63–0.82), and AUROC of 0.81. At day 7 (15 studies; n = 1,790), sensitivity and specificity results improved to 0.78 (0.71–0.84) and 0.83 (0.78–0.87), respectively; and AUROC to 0.88. Day 14 performance was similar to that at day 7 (sensibility, 0.78; specificity, 0.84; AUROC, 0.87). By day 21 (4 studies; n = 619), the performance accuracy peaked [sensibility, 0.85 [0.73–0.92]; specificity, 0.86 [0.71–0.94]; and AUROC, 0.92]. Overall, positive likelihood ratios rose from 2.8 to 6.3 and negative ratios fell from 0.33 to 0.18. The heterogeneity decreased at the later intervals. Conclusion The diagnostic accuracy of LUS scoring for BPD improved from the first through the third weeks of life, approaching optimal levels by day 21. These findings support the integration of serial LUS assessments into neonatal care plans to enable earlier, non-invasive BPD diagnosis. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251085780 , PROSPERO CRD420251085780.
Source: Frontiers in Pediatrics
Authors: Chundi Han, Xiaohua Wang, Minli Pan, Xueyin Huang
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4417417746