Prediction of fetal lung immaturity using gestational age, patient characteristics and fetal lung maturity tests: a probabilistic approach
The lecithin/sphingomyelin (L/S) ratio and the lamellar body count (LBC) can be used to predict respiratory distress syndrome (RDS).
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.
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.
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.
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- Prediction of fetal lung immaturity using gestational age, patient characteristics and fetal lung maturity tests: a probabilistic approach
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Archives of Gynecology and Obstetrics
Volume 281, Issue 1 , pp 15-21
- Cover Date
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- Fetal lung maturity
- Lamellar body count
- L/S ratio
- Respiratory distress sydrome (RDS)
- Industry Sectors
- Author Affiliations
- 1. Department of Obstetrics, Neonatology and Gynaecology, University Medical Center Utrecht, KJ02.507.0 Wilhelmina Children’s Hospital, PO Box 85090, 3508 AB, Utrecht, The Netherlands
- 2. Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
- 3. Departments of Clinical Chemistry, University Medical Center Utrecht, Utrecht, The Netherlands
- 4. Departments of Obstetrics, Isala Clinics, Location Sophia, Zwolle, The Netherlands
- 5. Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands
- 6. Department of Obstetrics and Gynaecology, Academic Medical Center, Amsterdam, The Netherlands