title: Evaluation of specificity and sensitivity of gastric aspirate shake test to predict surfactant deficiency in Iranian premature infants.
abstract: BACKGROUND
  Respiratory failure secondary to pulmonary surfactant deficiency is an important cause of severe respiratory distress in term and preterm infants. The aim of this study was to evaluate the specificity and sensitivity of gastric aspirate shake test (GAST) to predict surfactant deficiency in newly born premature infants in Arash Hospital (Iran) during 2012-13.
  
  
  METHODS
  In this case-control study, the case group comprised 69 premature infants (gestational age<37 weeks) who were admitted to the neonatal intensive care unit due to respiratory distress. The control group included 50 healthy infants .GAST test was done. The subjects were finally categorized as healthy or surfactant-deficient based on clinical and radiological assessments.
  
  
  RESULTS
  Using statistical methods the sensitivity, specificity, and positive and negative predictive values of GAST were 60%, 75%, 15%, and 52%, respectively. There was a significant difference between respiratory distress syndrome (RDS) scores and receiving surfactant in neonates with gestational age below 34 weeks. Moreover, there were significant differences between GAST results and both radiological findings of RDS and receiving oxygen in premature infants (gestational age<34 weeks). Negative GAST results were more prevalent in neonates who were born to mothers with hypothyroidism, preeclampsia, diabetes mellitus, and premature rupture of membranes. However, this difference was not significant.
  
  
  CONCLUSIONS
  According to our findings, the application of GAST on gastric aspirate secretions is not a useful method to predict surfactant deficiency. Therefore, decisions for RDS management must be made based on clinical and radiological findings.
authors.affiliation: Ghazvin Univercity of Medical Sciences, Ghazvin, Iran.
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Mehrpisheh
authors.affiliation: Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ziba
authors.initials: Z
authors.lastname: Mosayebi
authors.affiliation: Iran University of Medical Sciences, Tehran, Iran. Electronic address: azade.memariam@gmail.com.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Memarian
authors.affiliation: Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Malihe
authors.initials: M
authors.lastname: Kadivar
authors.affiliation: Arash Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Nariman
authors.affiliation: Zabol University of Medical Sciences, Zahedan, Iran.
authors.forename: Pouya
authors.initials: P
authors.lastname: Ostadrahimi
authors.affiliation: Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hosein
authors.initials: H
authors.lastname: Dalili
mesh_terms: D001034:Apgar Score; D016022:Case-Control Studies; D005260:Female; D005750:Gastric Juice / Q000737:chemistry; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015997:Neonatal Screening / Q000379:methods; D037661:Pulmonary Surfactant-Associated Proteins / Q000172:deficiency*; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants
keywords: Gastric aspirate shake test; Newborn; Preterm; Surfactant