The probability of neonatal respiratory distress syndrome as a function of gestational age and lecithin/sphingomyelin ratio.
We sought to define the risk of neonatal respiratory distress syndrome (RDS) as a function of both lecithin/sphingomyelin (L/S) ratio and gestational age. Amniotic fluid L/S ratio data were collected from consecutive women undergoing amniocentesis for fetal lung maturity at Yale-New Haven Hospital from January 1998 to December 2004. Women were included in the study if they delivered a live-born, singleton, nonanomalous infant within 72 hours of amniocentesis. The probability of RDS was modeled using multivariate logistic regression with L/S ratio and gestational age as predictors. A total of 210 mother-neonate pairs (8 RDS, 202 non-RDS) met criteria for analysis. Both gestational age and L/S ratio were independent predictors of RDS. A probability of RDS of 3% or less was noted at an L/S ratio cutoff of > or = 3.4 at 34 weeks, > or = 2.6 at 36 weeks, > or = 1.6 at 38 weeks, and > or = 1.2 at term. Under 34 weeks of gestation, the prevalence of RDS was so high that a probability of 3% or less was not observed by this model. These data describe a means of stratifying the probability of neonatal RDS using both gestational age and the L/S ratio and may aid in clinical decision making concerning the timing of delivery.
St Clair
Caryn
C
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA.
Norwitz
Errol R
ER
Woensdregt
Karlijn
K
Cackovic
Michael
M
Shaw
Julia A
JA
Malkus
Herbert
H
Ehrenkranz
Richard A
RA
Illuzzi
Jessica L
JL
D000653:Amniotic Fluid / Q000737:chemistry*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D054709:Lecithins / Q000032:analysis*; D016015:Logistic Models; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D018570:Risk Assessment; D013109:Sphingomyelins / Q000032:analysis*
D054709:Lecithins; D013109:Sphingomyelins
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