Gestational age-specific predicted risk of neonatal respiratory distress syndrome using lamellar body count and surfactant-to-albumin ratio in amniotic fluid.

Abstract

OBJECTIVE:

This study was undertaken to study the statistical correlation between lecithin/sphingomylein (L/S) ratio, percent phosphatidylglycerol (%PG), lamellar body count (LBC), and surfactant-to-albumin ratio (TDx-FLM(II)) in amniotic fluid (AF); and derive gestational age-specific (GA) predicted risk of neonatal respiratory distress syndrome (RDS) for LBC and TDx-FLM(II).

STUDY DESIGN:

AF specimens (238) were collected by transabdominal amniocentesis. L/S ratio, %PG, LBC, and TDx-FLM(II) were determined by established procedures. RDS diagnosis was ascertained by a neonatalogist, and statistical analyses were performed with the use of the SPSS software program (SPSS Inc, Chicago, Ill).

RESULTS:

Significant correlation was obtained among the 4 variables (L/S ratio, %PG, LBC, and TDx-FLM(II)). Independent linear regression analyses between L/S ratio versus LBC and TDx-FLM(II) provided acceptable correlation. Multiple regression analysis showed a significant (P < .001) contribution from TDx-FLM(II) and GA for predicting the L/S ratio. Receiver operating characteristic curve analysis provided the immature cutoffs (LBC = < 30.0 x 10(3)/microL; TDx-FLM(II) = < 40.0 mg/g). Total accuracy (either positive or negative) for RDS was similar for LBC (75.5%) and TDx-FLM(II) (76.7%).

CONCLUSION:

LBC and TDx-FLM(II) are equally accurate. GA-specific predicted risk of RDS by both tests significantly eliminated L/S ratio identified false positive cases of fetal lung maturity.

• Authors: Raymond Karcher, Elizabeth Sykes, Daniel Batton, Zi Uddin, Gary Ross, Elaine Hockman, George H Shade Jr
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 193 Issue 5 Pg. 1680-4 (Nov 2005) ISSN: 1097-6868 [Electronic] United States
• PMID: 16260210 (Publication Type: Journal Article)

Chemical References

• Albumins
• Pulmonary Surfactants

Topics

• Adolescent
• Adult
• Albumins (analysis)
• Amniotic Fluid (chemistry)
• Fetal Organ Maturity
• Gestational Age
• Humans
• Infant, Newborn
• Lung (embryology)
• Middle Aged
• Pulmonary Surfactants (analysis)
• Respiratory Distress Syndrome, Newborn (diagnosis, epidemiology)
• Risk Factors