Prediction of fetal lung immaturity using gestational age, patient characteristics and fetal lung maturity tests: a probabilistic approach.
OBJECTIVE
The lecithin/sphingomyelin (L/S) ratio and the lamellar body count (LBC) can be used to predict respiratory distress syndrome (RDS).


METHODS
We performed a retrospective cohort study among consecutive women who underwent amniotic fluid sampling for the assessment of fetal lung maturity. Logistic regression was used to construct models for the prediction of RDS in three gestational age categories, with models based on clinical characteristics only, clinical characteristics and the LBC, and on clinical characteristics and L/S ratio.


RESULTS
When amniotic fluid was collected <30 weeks, the specificity of the LBC was 30% and the sensitivity 100%. Addition of the L/S ratio increased the specifity to 60%, for a sensitivity of 100%. When amniocentesis was performed between 30 and 33 weeks, addition of the L/S ratio only marginally improved the performance of the LBC.


CONCLUSIONS
At a gestational age <30 weeks, the L/S ratio has additional value over the LBC. Above 30 weeks of gestation, single use of the LBC seems sufficient.
Wijnberger
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LD
Department of Obstetrics, Neonatology and Gynaecology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands. l.wijnberger@xs4all.nl
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D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D015233:Models, Statistical; D011237:Predictive Value of Tests; D011247:Pregnancy; D011663:Pulmonary Surfactants / Q000032:analysis*; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis; D012189:Retrospective Studies
D011663:Pulmonary Surfactants