Am J Perinatol 2008; 25(8): 473-480
DOI: 10.1055/s-0028-1085066
© Thieme Medical Publishers

The Probability of Neonatal Respiratory Distress Syndrome as a Function of Gestational Age and Lecithin/Sphingomyelin Ratio

Caryn St. Clair1 , Errol R. Norwitz1 , Karlijn Woensdregt1 , Michael Cackovic1 , Julia A. Shaw1 , Herbert Malkus2 , Richard A. Ehrenkranz3 , Jessica L. Illuzzi1
  • 1Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut
  • 2Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 3Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
Further Information

Publication History

Publication Date:
04 September 2008 (online)

ABSTRACT

We sought to define the risk of neonatal respiratory distress syndrome (RDS) as a function of both lecithin/sphingomyelin (L/S) ratio and gestational age. Amniotic fluid L/S ratio data were collected from consecutive women undergoing amniocentesis for fetal lung maturity at Yale-New Haven Hospital from January 1998 to December 2004. Women were included in the study if they delivered a live-born, singleton, nonanomalous infant within 72 hours of amniocentesis. The probability of RDS was modeled using multivariate logistic regression with L/S ratio and gestational age as predictors. A total of 210 mother-neonate pairs (8 RDS, 202 non-RDS) met criteria for analysis. Both gestational age and L/S ratio were independent predictors of RDS. A probability of RDS of 3% or less was noted at an L/S ratio cutoff of ≥ 3.4 at 34 weeks, ≥ 2.6 at 36 weeks, ≥ 1.6 at 38 weeks, and ≥ 1.2 at term. Under 34 weeks of gestation, the prevalence of RDS was so high that a probability of 3% or less was not observed by this model. These data describe a means of stratifying the probability of neonatal RDS using both gestational age and the L/S ratio and may aid in clinical decision making concerning the timing of delivery.

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Jessica L IlluzziM.D. M.S. 

c/o Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine

PO Box 208063, New Haven, CT 06520-8063

Email: jessica.illuzzi@yale.edu