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  • Title: Gestational age-specific predicted risk of neonatal respiratory distress syndrome using lamellar body count and surfactant-to-albumin ratio in amniotic fluid.
    Author: Karcher R, Sykes E, Batton D, Uddin Z, Ross G, Hockman E, Shade GH.
    Journal: Am J Obstet Gynecol; 2005 Nov; 193(5):1680-4. PubMed ID: 16260210.
    Abstract:
    OBJECTIVE: This study was undertaken to study the statistical correlation between lecithin/sphingomylein (L/S) ratio, percent phosphatidylglycerol (%PG), lamellar body count (LBC), and surfactant-to-albumin ratio (TDx-FLM(II)) in amniotic fluid (AF); and derive gestational age-specific (GA) predicted risk of neonatal respiratory distress syndrome (RDS) for LBC and TDx-FLM(II). STUDY DESIGN: AF specimens (238) were collected by transabdominal amniocentesis. L/S ratio, %PG, LBC, and TDx-FLM(II) were determined by established procedures. RDS diagnosis was ascertained by a neonatalogist, and statistical analyses were performed with the use of the SPSS software program (SPSS Inc, Chicago, Ill). RESULTS: Significant correlation was obtained among the 4 variables (L/S ratio, %PG, LBC, and TDx-FLM(II)). Independent linear regression analyses between L/S ratio versus LBC and TDx-FLM(II) provided acceptable correlation. Multiple regression analysis showed a significant (P < .001) contribution from TDx-FLM(II) and GA for predicting the L/S ratio. Receiver operating characteristic curve analysis provided the immature cutoffs (LBC = < 30.0 x 10(3)/microL; TDx-FLM(II) = < 40.0 mg/g). Total accuracy (either positive or negative) for RDS was similar for LBC (75.5%) and TDx-FLM(II) (76.7%). CONCLUSION: LBC and TDx-FLM(II) are equally accurate. GA-specific predicted risk of RDS by both tests significantly eliminated L/S ratio identified false positive cases of fetal lung maturity.
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