Risk assessment for neonatal RDS/TTN using gestational age and the amniotic lamellar body count in twin pregnancies

Tsuda, Hiroyuki; Hirakawa, Akihiro; Kotani, Tomomi; Sato, Seiji; Mano, Yukio; Nakano, Tomoko; Imai, Kenji; Kawabata, Ichiro; Takahashi, Yuichiro; Iwagaki, Shigenori; Kikkawa, Fumitaka

doi:10.1016/j.cca.2015.10.013

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…These findings are in line with those reported by Tsuda et al [ 23 ], who evaluated a model combining gestational age and lamellar body count (LBC) to predict NRM in twins. They reported a sensitivity of 69.0% and a specificity of 88.0% for the best cut-off value, which is in line with our results in the gestational age group <32 weeks, and obtained a specificity of 97.0% for predicting RDS/TTN, although in the gestational age group >37 weeks, the diagnostic accuracy decreased compared to the preterm period.…”

Section: Discussionsupporting

confidence: 92%

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Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies

Moreno-Espinosa

Hawkins-Villarreal

Coronado-Gutiérrez

et al. 2022

JCM

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The objective of this study was to evaluate the performance of quantitative ultrasound of fetal lung texture analysis in predicting neonatal respiratory morbidity (NRM) in twin pregnancies. This was an ambispective study involving consecutive cases. Eligible cases included twin pregnancies between 27.0 and 38.6 weeks of gestation, for which an ultrasound image of the fetal thorax was obtained within 48 h of delivery. Images were analyzed using quantusFLM® version 3.0. The primary outcome of this study was neonatal respiratory morbidity, defined as the occurrence of either transient tachypnea of the newborn or respiratory distress syndrome. The performance of quantusFLM® in predicting NRM was analyzed by matching quantitative ultrasound analysis and clinical outcomes. This study included 166 images. Neonatal respiratory morbidity occurred in 12.7% of cases, and it was predicted by quantusFLM® analysis with an overall sensitivity of 42.9%, specificity of 95.9%, positive predictive value of 60%, and negative predictive value of 92.1%. The accuracy was 89.2%, with a positive likelihood ratio of 10.4, and a negative likelihood ratio of 0.6. The results of this study demonstrate the good prediction capability of NRM in twin pregnancies using a non-invasive lung texture analysis software. The test showed an overall good performance with high specificity, negative predictive value, and accuracy.

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Section: Discussionsupporting

confidence: 92%

“…The overall prevalence of NRM in our population was 12.7%, which is in line with that reported by Tsuda et al, using the amniotic lamellar body count (LBC) as a predictive tool in different series of twin pregnancies [ 1 , 23 ]. Other studies have reported prevalence of up to 19% including TTN and RDS [ 2 ].…”

Section: Discussionsupporting

confidence: 91%

Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies

Moreno-Espinosa

Hawkins-Villarreal

Coronado-Gutiérrez

et al. 2022

JCM

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“…These two findings are novel as, to the best of our knowledge, LBC had never been tested in these conditions or aiming to predict CPAP failure in neonates with established RDS, while LBC has been used to predict RDS occurrence [14, 17, 33]. Our results might seem conflicting with experimental data showing increased LBC in lung tissue of animals treated with prenatal steroids.…”

Section: Discussionmentioning

confidence: 68%

“…Gestational age, antenatal steroids, pre-eclampsia and LBC were inserted as covariates, since they had a p < 0.2 at the univariate comparison between CPAP success and failure cohorts. An alternative model was also tested including an interaction term between LBC and gestational age, as both these variables are significantly associated to RDS occurrence [33]. In order to avoid multicollinearity, birth weight was not used, since it is highly correlated with gestational age and SGA babies were not different between the two cohorts.…”

Section: Methodsmentioning

confidence: 99%

Estimation of early life endogenous surfactant pool and CPAP failure in preterm neonates with RDS

et al. 2019

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Background It is not known if the endogenous surfactant pool available early in life is associated with the RDS clinical course in preterm neonates treated with CPAP. We aim to clarify the clinical factors affecting surfactant pool in preterm neonates and study its association with CPAP failure. Methods Prospective, pragmatic, blind, cohort study. Gastric aspirates were obtained (within the first 6 h of life and before the first feeding) from 125 preterm neonates with RDS. Surfactant pool was measured by postnatal automated lamellar body count based on impedancemetry, without any pre-analytical treatment. A formal respiratory care protocol based on European guidelines was applied. Clinical data and perinatal risk factors influencing RDS severity or lamellar body count were real-time recorded. Investigators performing lamellar body count were blind to the clinical data and LBC was not used in clinical practice. Results Multivariate analysis showed gestational age to be the only factor significantly associated with lamellar body count (standardized β:0.233; p = 0.023). Lamellar body count was significantly higher in neonates with CPAP success (43.500 [23.750–93.750]bodies/μL), than in those failing CPAP (20.500 [12.250–49.750] bodies/μL; p = 0.0003).LBC had a moderate reliability to detect CPAP failure (AUC: 0.703 (0.615–0.781); p < 0.0001; best cut-off: ≤30,000 bodies/μL). Upon adjustment for possible confounders, neither lamellar body count, nor its interaction factor with gestational age resulted associated with CPAP failure. Conclusions Early postnatal lamellar body count on gastric aspirates in CPAP-treated preterm neonates with RDS is significantly influenced only by gestational age. Lamellar bodies are not associated with CPAP failure. Thus, the endogenous surfactant pool available early in life only has a moderate reliability to predict CPAP failure.

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“…However, the TDx FLM-II was recently discontinued necessitating a need for a replacement method with at least a similar level of accuracy and automation. One option available was the lamellar body count, an assay that measures a stored form of surfactant in the amniotic fluid using a standard hematology analyser [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Fetal Lung Maturity by Lamellar Body Count (LBC) in Comparison to the Fluorescence Polarization TDx FLM-II and L/S Ratio Methods

Williams¹,

Akl²,

Blick³

2017

J Neonatal Biol

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Risk assessment for neonatal RDS/TTN using gestational age and the amniotic lamellar body count in twin pregnancies

Cited by 7 publications

References 17 publications

Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies

Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies

Estimation of early life endogenous surfactant pool and CPAP failure in preterm neonates with RDS

Assessment of Fetal Lung Maturity by Lamellar Body Count (LBC) in Comparison to the Fluorescence Polarization TDx FLM-II and L/S Ratio Methods

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