Prediction of respiratory distress syndrome by the novel dipalmitoyl phosphatidylcholine test.
OBJECTIVE
To determine the accuracy of a new test that measures the concentration in amniotic fluid (AF) of dipalmitoyl phosphatidylcholine (DPPC) in predicting respiratory distress syndrome (RDS).


METHODS
The neonatal respiratory status of 176 newborns delivered within 72 hours of sampling was correlated with the concentration of DPPC, fluorescence polarization (TDx-FLM), lecithin-sphingomyelin ratio (L/S), and phosphatidyl-glycerol (Amniostat-FLM) in AF.


RESULTS
Thirty infants developed RDS (17%), all correctly predicted with DPPC values less than 12 micrograms/mL (sensitivity 100%). Only six of the 146 cases with no RDS had DPPC values less than 12 micrograms/mL (specificity 96%). The overall accuracy of the DPPC test was 98% compared with 70% for TDx-FLM, 71% for the L/S, and 67% for Amniostat-FLM. Receiver operating characteristic analysis area was 0.98 +/- 0.01, indicating that the DPPC test is superior to both the TDx-FLM and L/S tests.


CONCLUSIONS
The DPPC test is an accurate predictor of RDS and fetal lung maturity.
Alvarez
J G
JG
Department of Obstetrics and Gynecology, Beth Israel Hospital, Harvard Medical School, Boston, MA, USA.
Richardson
D K
DK
Ludmir
J
J
D015060:1,2-Dipalmitoylphosphatidylcholine / Q000032:analysis*; D000653:Amniotic Fluid / Q000737:chemistry*; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010713:Phosphatidylcholines / Q000032:analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011296:Prenatal Diagnosis; D012372:ROC Curve; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis*; D013109:Sphingomyelins / Q000032:analysis
D010713:Phosphatidylcholines; D013109:Sphingomyelins; D015060:1,2-Dipalmitoylphosphatidylcholine