title: Risk assessment for neonatal RDS/TTN using gestational age and the amniotic lamellar body count in twin pregnancies.
abstract: BACKGROUND
  The amniotic lamellar body count (LBC) is useful for predicting respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN) in twin pregnancies. However, the risk of neonatal respiratory complications varies with gestational age (GA). We herein created a model to predict the risk for RDS and TTN using GA and the LBC in twin pregnancies.
  
  
  METHODS
  Six hundred thirty-two amniotic fluid samples, comprising 169 dichorionic twin (DCT) and 147 monochorionic twin (MCT) gestations, were obtained at Cesarean section. The samples were analyzed immediately without centrifugation. A logistic regression model including the LBC and GA was used to develop the prediction model for RDS/TTN.
  
  
  RESULTS
  There were 101 neonates (16.0%) with RDS/TTN. The GA and LBC were significant independent factors affecting RDS/TTN. According to the logistic regression model, we determined the probability of RDS/TTN given the values of GA and the LBC. The overall diagnostic accuracy for predicting neonatal RDS/TTN using GA and the LBC was higher than the use of the LBC alone.
  
  
  CONCLUSIONS
  GA-specific LBC cutoffs for the risk assessment of neonatal RDS/TTN have been considered to be more accurate in twin pregnancies. Our findings provide valuable, new information for the management of twin pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan; Department of Fetal and Maternal Medicine, Nagara Medical Center, Gifu City, Japan. Electronic address: hiro-t@med.nagoya-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuda
authors.affiliation: Biostatics Laboratory, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirakawa
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kotani
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Sumigama
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Mano
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Imai
authors.affiliation: Department of Fetal and Maternal Medicine, Nagara Medical Center, Gifu City, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawabata
authors.affiliation: Department of Fetal and Maternal Medicine, Nagara Medical Center, Gifu City, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Fetal and Maternal Medicine, Nagara Medical Center, Gifu City, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Iwagaki
authors.affiliation: Department of Obstetrics and Gynecology, Nagoya, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
mesh_terms: D000653:Amniotic Fluid / Q000737:chemistry*; D005260:Female; D005325:Fetal Organ Maturity; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D011247:Pregnancy; D059285:Pregnancy, Twin; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000503:physiopathology; D018570:Risk Assessment; D059245:Transient Tachypnea of the Newborn / Q000175:diagnosis* / Q000503:physiopathology
keywords: Gestational age; Lamellar body; Respiratory distress syndrome; Transient tachypnea of the newborn; Twin pregnancy