Role of lamellar body count for the prediction of neonatal respiratory distress syndrome in non-diabetic pregnant women

Arch Gynecol Obstet. 2005 Apr;271(4):325-8. doi: 10.1007/s00404-004-0653-7. Epub 2004 Jun 18.

Abstract

Objective: Lamellar body count is a new and fast technique to establish the presence of fetal lung maturity. We have assessed the predictive ability of lamellar body count for neonatal respiratory distress syndrome (RDS) in a non-diabetic population.

Study design: We accessed a cohort of amniocenteses in non-diabetic women from 1998 to 2002 (n=102). Neonatal RDS was defined as need for surfactant, intubation, or continuous positive airway pressure (CPAP) in the setting of chest X-ray findings consistent with RDS. The predictive ability of lamellar body count was compared with those of lecithin/sphingomyelin (L/S) ratio and presence of phosphatidylglycerol (PG) using logistic regression analysis. The optimal threshold value of lamellar body count for prediction of neonatal RDS was established with receiver operating characteristic (ROC) curve analysis.

Results: Lamellar body count ROC curve analysis identified a lamellar body count >37,000 microl(-1) as optimal diagnostic threshold for diagnosis of lung maturity, having a negative predictive value of 98%. Lamellar body count and PG, but not L/S ratio, added significantly to the prediction of RDS.

Conclusions: Lamellar body count is a reliable predictor of fetal lung maturity in non-diabetic women and it can replace the L/S ratio.

MeSH terms

  • Amniocentesis
  • Amniotic Fluid / chemistry
  • Amniotic Fluid / cytology
  • Cohort Studies
  • Diagnostic Techniques, Respiratory System / instrumentation*
  • Female
  • Fetal Organ Maturity*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Lung / cytology
  • Lung / embryology*
  • Phosphatidylcholines / analysis
  • Predictive Value of Tests
  • Pregnancy
  • Prenatal Diagnosis*
  • ROC Curve
  • Respiratory Distress Syndrome, Newborn / diagnosis*
  • Respiratory Mucosa / cytology
  • Respiratory Mucosa / embryology
  • Retrospective Studies
  • Sphingomyelins / analysis

Substances

  • Phosphatidylcholines
  • Sphingomyelins