Neonatal Respiratory Distress Syndrome as a Function of Gestational Age and the Lecithin/Sphingomyelin Ratio
Data was collected via a retrospective chart review. Women who underwent amniocentesis for the purpose of assessing fetal lung maturity at Yale-New Haven Hospital from 1998 to 2004 were identified and included if delivery of a liveborn, singleton, non-anomalous infant occurred within 72 hours of the lecithin/sphingomyelin ratio assay. Maternal and neonatal data were collected regarding demographics, pregnancy complications and neonatal outcomes, including respiratory distress syndrome.
A total of 210 mother-neonate pairs met criteria for analysis, with 8 cases of RDS. Both gestational age and L/S ratio were independent predictors of RDS. By modeling the odds of RDS using logistic regression, a probability of RDS approximating 10% was noted at an L/S cutoff of 3.6 at 32 weeks, 2.8 at 34 weeks, 1.8 at 36 weeks, and 1.4 at term. Under 32 weeks of gestation a probability as low as 10% was not observed by this model. We conclude that stratifying risk of neonatal RDS using both the L/S ratio and gestational age may aid in clinical decision-making concerning the timing of delivery.
School Location:USA - Connecticut
Source Type:Master's Thesis
Keywords:gestational age sphingomyelins respiratory distress syndrome newborn infant
Date of Publication:09/08/2008