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


METHODS
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.
Ghidini
Alessandro
A
Department of Obstetrics and Gynecology, Georgetown University Hospital, 3PHC 3800 Reservoir Road, N.W., Washington, DC 20007, USA. alessandro.ghidini@inova.com
Poggi
Sarah H
SH
Spong
Catherine Y
CY
Goodwin
Katie M
KM
Vink
Joy
J
Pezzullo
John C
JC
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry / Q000166:cytology; D015331:Cohort Studies; D003948:Diagnostic Techniques, Respiratory System / Q000295:instrumentation*; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008168:Lung / Q000166:cytology / Q000196:embryology*; D010713:Phosphatidylcholines / Q000032:analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012372:ROC Curve; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis*; D020545:Respiratory Mucosa / Q000166:cytology / Q000196:embryology; D012189:Retrospective Studies; D013109:Sphingomyelins / Q000032:analysis
D010713:Phosphatidylcholines; D013109:Sphingomyelins