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Investigating the use of ultrasonography for the antenatal diagnosis of structural congenital anomalies in low-income and middle-income countries: systematic review protocol
  1. Stephanie Michele Goley1,
  2. Sidonie Sakula-Barry2,
  3. Ann Kelly1,
  4. Naomi Wright3
  1. 1Department of Global Health & Social Medicine, King's College London, UK
  2. 2World Cancer Research Fund, London, UK
  3. 3King’s Centre for Global Health and Health Partnerships, King's College, London, UK
  1. Correspondence to Stephanie Michele Goley; stephanie.goley{at}


Introduction Congenital anomalies are the fifth leading cause of mortality in children under 5 years globally. The greatest burden is faced by those in developing countries, where over 95% of deaths occur. Many of these deaths may have been preventable through antenatal diagnosis and early intervention. This study aims to conduct a systematic review that investigates the use of antenatal ultrasound to diagnose congenital anomalies and improve the health outcomes of infants in low-income and middle-income countries (LMICs).

Methods and analysis A systematic literature review will be conducted using three search strings: (1) structural congenital anomalies, (2) LMICs and (3) antenatal diagnosis. Four electronic databases will be searched: MEDLINE, Embase, PubMed and the Cochrane Library. Title, abstract and full-text screening will be undertaken in duplicate by two reviewers independently using Covidence. Consensus will be sought from the wider authorship for discrepancies. Data extraction will be undertaken by the principal investigator. The primary analysis will focus on the availability and effectiveness of antenatal ultrasound for structural congenital anomalies. Secondary outcomes will include neonatal morbidity and mortality, termination rates and referral rates for further antenatal care. Descriptive statistics and a narrative synthesis will be included in the final report. The methodological quality of the included studies will be evaluated using the Cochrane-approved Risk of Bias for Non-Randomised Studies of Intervention and Risk of Bias in Randomised Trials V.2.0 tools.

Ethics and dissemination Ethical approval is not required for conducting the systematic review as there will be no direct collection of data from individuals. The results will be submitted for publication in a scientific journal and presented internationally.

Conclusion This is the first study, to our knowledge, to systematically review current literature on the use of antenatal ultrasound for the detection of congenital anomalies in LMICs. This is vital to define current practice, highlight global disparities and evaluate effects on health outcomes for infants in low-resource settings.

PROSPERO registration number CRD42019105620.

  • Congenital Abnorm
  • Paediatric Surgery
  • Neonatology
  • Imaging

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  • Contributors NW conceived the idea for this study. All authors devised the study design. SMG drafted the protocol with significant contributions from NW and AK. SMG and SSB will perform the literature review and SMG will draft the results.

  • Funding NW receives funding from the Wellcome Trust with the funding refererence [203905/Z/16/Z].

  • Disclaimer Since this is a protocol, there is no supporting data.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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