Predicting neonatal respiratory morbidity by lamellar body count and gestational age
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Carmen Beamon
Abstract
Aims:
To develop a predictive model for assessing the risk of developing neonatal respiratory morbidity using lamellar body counts (LBCs) and gestational age (GA) to provide a more patient-specific assessment.
Methods:
Retrospective cohort study of patients’ ≥32 weeks’ gestation who received amniocentesis with LBC analysis over a 9-year period. Respiratory morbidity was defined as respiratory distress syndrome, transient tachypnea of the newborn or oxygen requirement for >24 h. Logistic regression analyses were used to predict the absolute risk and odds of respiratory morbidity as a function of GA and lamellar body count.
Results:
Two hundred and sixty-seven mother-infant pairs included in the analysis with 32 cases (12.0%) of respiratory morbidity. When compared to those without respiratory morbidity, neonates with respiratory morbidity had amniocentesis performed at an earlier median GA, had lower mean birthweight and had lower median LBC (P<0.01). The GA specific absolute risks and odds ratios for the presence of respiratory morbidity were calculated. The predicted absolute risks of neonatal respiratory morbidity ranged from 38% at 32 weeks to 6% at 40 weeks when LBC were 35,000/μL.
Conclusion:
GA specific predicted risk of neonatal respiratory morbidity using LBC provides a statistical model, which can aid clinicians in individually counseling patients regarding the absolute risk of their neonate developing respiratory morbidity.
References
[1] American College of Obstetricians and Gynecologists. Fetal lung maturity. ACOG Practice Bulletin No. 97. Obstet Gynecol. 2008;112:717–26.10.1097/AOG.0b013e318188d1c2Search in Google Scholar
[2] Grenache DG, Wilson AR, Gross GA, Gronowski AM. Clinical and laboratory trends in fetal lung maturity testing. Clin Chim Acta. 2010;411:1746–9.10.1016/j.cca.2010.07.025Search in Google Scholar
[3] American College of Obstetricians and Gynecologists. Antenatal corticosteroid therapy for fetal maturation. ACOG Committee Opinion No. 475. Obstet Gynecol. 2011;117:422–4.10.1097/AOG.0b013e31820eee00Search in Google Scholar
[4] Haymond S, Luzzi VI, Parvin CA, Gronowski AM. A direct comparison between lamellar body counts and fluorescent polarization methods for predicting respiratory distress syndrome. Am J Clin Pathol. 2006;126:894–9.10.1309/8VXN5EM5L3831AT2Search in Google Scholar
[5] Janicki MB, Dries LM, Egan JF, Zelop CM. Determining a cut-off for fetal lung maturity with lamellar body count testing. J Matern Fetal Neonatal Med. 2009;22:419–22.10.1016/j.ajog.2007.10.545Search in Google Scholar
[6] Karcher R, Sykes E, Batton D, Uddin Z, Ross G, Hockman E, et al. Gestational age-specific predicted risk of neonatal respiratory distress syndrome using lamellar body count and surfactant-to-albumin ratio in amniotic fluid. Am J Obstet Gynecol. 2005;193:1680–4.10.1016/j.ajog.2005.03.080Search in Google Scholar
[7] Khazardoost S, Yahyazadeh H, Borna S, Sohrabvand F, Yahyazadeh N, Amini E. Amniotic fluid lamellar body count and its sensitivity and specificity in evaluating of fetal lung maturity. J Obstet Gynaecol. 2005;25:257–9.10.1080/01443610500060750Search in Google Scholar
[8] Neerhof MG, Haney EI, Silver RK, Ashwood ER, Lee IS, Piazze JJ. Lamellar body counts compared with traditional phospholipid analysis as an assay for evaluating fetal lung maturity. Obstet Gynecol. 2001;97:305–9.Search in Google Scholar
[9] Piazze J, Cerekja A. Lamellar bodies: platelet channel particles as predictors of respiratory distress syndrome (RDS) and of transient tachypnea of the newborn. J Perinat Med. 2011;39:349–51.10.1515/jpm.2011.007Search in Google Scholar
[10] Piazze JJ, Maranghi L, Cerekja A, Meloni P, Gioia S, Fumian L, et al. Amniotic fluid lamellar body counts for the determination of fetal lung maturity: an update. J Perinat Med. 2005;33:156–60.10.1515/JPM.2005.029Search in Google Scholar
[11] Kaplan LA, Chapman JF, Bock JL, Santa Maria E, Clejan S, Huddleston DJ, et al. Prediction of respiratory distress syndrome using the Abbott FLM-II amniotic fluid assay. Clin Chim Acta. 2002;326:61–8.10.1016/S0009-8981(02)00336-4Search in Google Scholar
[12] Ghidini A, Poggi SH, Spong CY, Goodwin KM, Vink J, Pezzullo JC. Role of lamellar body count for the prediction of neonatal respiratory distress syndrome in non-diabetic pregnant women. Arch Gynecol Obstet. 2005;271:325–8.10.1007/s00404-004-0653-7Search in Google Scholar
[13] Lockwood CM, Crompton JC, Riley JK, Landeros K, Dietzen DJ, Grenache DG, et al. Validation of lamellar body counts using three hematology analyzers. Am J Clin Pathol. 2010;134:420–8.10.1309/AJCPWEUIM2CWUOV8Search in Google Scholar
[14] Szallasi A, Gronowski AM, Eby CS. Lamellar body count in amniotic fluid: a comparative study of four different hematology analyzers. Clin Chem. 2003;49:994–7.10.1373/49.6.994Search in Google Scholar
[15] Dalence CR, Bowie LJ, Dohnal JC, Farrell EE, Neerhof MG. Amniotic fluid lamellar body count: a rapid and reliable fetal lung maturity test. Obstet Gynecol. 1995;86:235–9.10.1016/0029-7844(95)00120-GSearch in Google Scholar
[16] Bates E, Rouse DJ, Mann ML, Chapman V, Carlo WA, Tita AT. Neonatal outcomes after demonstrated fetal lung maturity before 39 weeks of gestation. Obstet Gynecol. 2010;116:1288–95.10.1097/AOG.0b013e3181fb7eceSearch in Google Scholar PubMed PubMed Central
[17] Fang YM, Guirguis P, Borgida A, Feldman D, Ingardia C, Herson V. Increased neonatal morbidity despite pulmonary maturity for deliveries occurring before 39 weeks. J Matern Fetal Neonatal Med. 2013;26:79–82.10.3109/14767058.2012.728647Search in Google Scholar PubMed
[18] Kamath BD, Marcotte MP, DeFranco EA. Neonatal morbidity after documented fetal lung maturity in late preterm and early term infants. Am J Obstet Gynecol. 2011;204:518e1–8.10.1016/j.ajog.2011.03.038Search in Google Scholar PubMed PubMed Central
[19] Ventolini G, Neiger R, Hood DL, Belcastro MR. Changes in the threshold of fetal lung maturity testing and neonatal outcome of infants delivered electively before 39 weeks gestation: implications and cost-effectiveness. J Perinatol. 2006;26:264–7.10.1038/sj.jp.7211501Search in Google Scholar PubMed
[20] Chapman JF, Ashwood ER, Feld R, Wu AH. Evaluation of two-dimensional cytometric lamellar body counts on the ADVIA 120 hematology system for estimation of fetal lung maturation. Clin Chim Acta. 2004;340:85–92.10.1016/j.cccn.2003.09.024Search in Google Scholar PubMed
[21] Spong CY, Mercer BM, D’Alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011;118:323–33.10.1097/AOG.0b013e3182255999Search in Google Scholar PubMed PubMed Central
[22] Lu J, Gronowski AM, Eby CS. Lamellar body counts performed automated hematology analyzers to assess fetal lung maturity. Lab Med. 2008;39:419–23.10.1309/TPM3HYJE475RYMA2Search in Google Scholar
[23] Zhao Q, Zhao Z, Leung-Pineda V, Wiley CL, Nelson PJ, Grenache DG, et al. Predicting respiratory distress syndrome using gestational age and lamellar body count. Clin Biochem. 2013;46:1228–32.10.1016/j.clinbiochem.2013.03.020Search in Google Scholar
[24] Robertson PA, Sniderman SH, Laros RK, Jr., Cowan R, Heilbron D, Goldenberg RL, et al. Neonatal morbidity according to gestational age and birth weight from five tertiary care centers in the United States, 1983 through 1986. Am J Obstet Gynecol. 1992;166:1629–41.10.1016/0002-9378(92)91551-KSearch in Google Scholar
The authors stated that there are no conflicts of interest regarding the publication of this article.
©2016 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Editorial
- Prematurity
- Original articles - Prematurity
- Does progesterone administration in preterm labor influence Treg cells?
- Reliability of posterior-left atrium space index measurements during 20–24 weeks of gestation in structurally normal fetuses
- Intervention versus a conservative approach in the management of TRAP sequence: a systematic review
- Music-induced prolongation of heart rate corrected QT intervals from electrocardiogram recordings of healthy preterm pregnant women
- Music devices for the fetus? An evaluation of pregnancy music belts
- Communication about maternal-fetal surgery for myelomeningocele and congenital diaphragmatic hernia: preliminary findings with implications for informed consent and shared decision-making
- Randomized control trial comparing physiologic effects in preterm infants during treatment with nasal continuous positive airway pressure (NCPAP) generated by Bubble NCPAP and Ventilator NCPAP: a pilot study
- Clinical characteristics and factors associated with term and late preterm infants that do not respond to inhaled nitric oxide (iNO)
- Adipokine, adropin and endothelin-1 levels in intrauterine growth restricted neonates and their mothers
- Predicting neonatal respiratory morbidity by lamellar body count and gestational age
- Surfactant with and without bronchoalveolar lavage in an experimental model of meconium aspiration syndrome
- Academy’s Paper
- Neonates of mothers who have had kidney or liver transplantation
- Original articles - Obstetrics
- Arterio-venous differences in cord levels of catecholamines, glucose, lactate and blood gases
- Original articles - Newborn
- Genetic low nephron number hypertension is associated with altered expression of key components of the renin-angiotensin system during nephrogenesis
- Omega-3 fatty acids modulate neonatal cytokine response to endotoxin
- Short communication
- Reference values for the single deepest vertical pocket to assess the amniotic fluid volume in the second and third trimesters of pregnancy
- Congress Calendar
- Congress Calendar
