Prevalence Of Respiratory Distress Syndrome Research Articles

The accuracy of lamellar body count and lecithin/sphingomyelin ratio in the prediction of neonatal respiratory distress syndrome: a meta-analysis.

To compare the performance of the lecithin/sphingomyelin ratio and the lamellar body count in the prediction of neonatal respiratory distress syndrome. Meta-analysis. Six studies reporting on the performance of both the lecithin/sphingomyelin ratio and the lamellar body count published between January 1966 and August 1999. We performed a computerised MEDLINE search to identify articles published on the subject. For the six selected studies, prevalence of respiratory distress syndrome and sensitivity and specificity of the tests in the prediction of respiratory distress syndrome were calculated, and overall performance was assessed by constructing summary receiver-operating characteristic curves. The constructed summary receiver-operating characteristic curves showed the lamellar body count to perform slightly better than the lecithin/sphingomyelin ratio in the prediction of respiratory distress syndrome (P= 0.13). Since the lamellar body count can be performed quickly and since it is less expensive than the lecithin/sphingomyelin ratio, we recommend the former as the test of first choice in the assessment of fetal lung maturity.

The accuracy of lamellar body count and lecithin/sphingomyelin ratio in the prediction of neonatal respiratory distress syndrome: a meta-analysis

Objective To compare the performance of the lecithin/sphingomyelin ratio and the lamellar body count in the prediction of neonatal respiratory distress syndrome. Design Meta-analysis. Sample Six studies reporting on the performance of both the lecithin/sphingomyelin ratio and the lamellar body count published between January 1966 and August 1999. Methods We performed a computerised MEDLINE search to identify articles published on the subject. For the six selected studies, prevalence of respiratory distress syndrome and sensitivity and specificity of the tests in the prediction of respiratory distress syndrome were calculated, and overall performance was assessed by constructing summary receiver–operating characteristic curves. Results The constructed summary receiver–operating characteristic curves showed the lamellar body count to perform slightly better than the lecithin/sphingomyelin ratio in the prediction of respiratory distress syndrome ( P= 0.13). Conclusions Since the lamellar body count can be performed quickly and since it is less expensive than the lecithin/sphingomyelin ratio, we recommend the former as the test of first choice in the assessment of fetal lung maturity.

Neonatal respiratory distress syndrome in Karachi: some epidemiological considerations.

Although respiratory distress syndrome (RDS) is a leading cause of neonatal morbidity and mortality in the west, there are few data on the prevalence and spectrum of RDS from developing countries. Available evidence suggests that the disorder may be less common than the overall 1% incidence reported from developed countries. In a prospective study of the prevalence of RDS in a consecutive 10,134 births at the Aga Khan University Hospital, we documented the disorder in 127 (1.2% births), with a prevalence of 12.8% among low birthweight infants. The overall mortality for this group was 39%, with the highest mortality rate (68%) among newborn infants < or = 1000 g birthweight. Our data from a large and relatively well-nourished hospital-born population in Karachi suggest that RDS is a significant cause of morbidity and mortality in preterm infants with a similar prevalence rate to western figures.

Maternal and neonatal morbidity associated with in vitro fertilization

Objective: The purpose of this case-control study was to examine the maternal and neonatal morbidities associated with in vitro fertilization (IVF) in a single large teaching hospital. It was hypothesized that IVF mothers would have more perinatal complications and IVF infants would have higher mortality and morbidity rates than non-IVF control subjects. Methods: One hundred forty-three gestations resulting from 101 IVF pregnancies, which included singletons (n = 62), twins (n = 72), and triplets (n = 9), were compared with equal numbers of non-IVF control subjects. Each pregnancy was matched by maternal age, race, insurance type, neonatal gender, order of gestation, order in delivery, and date of delivery (±6 months). Among the 143 matched gestations, six IVF and seven control infants died, leaving 137 IVF and 136 control neonates for comparison. Results: The IVF mothers had more pregnancy-induced hypertension (21% vs 4%), premature labor (44% vs 22%), labor induction (25% vs 1%), and preterm delivery (37% vs 21%). The IVF infant survivors had a lower mean (±SD) birth weight (2623 ± 857 gm vs 3006 ± 797 gm), more frequent occurrence of low birth weight (42% vs 27%), and shorter gestations (37 ± 4 vs 38 ± 3 weeks). The IVF infants had longer hospitalizations, more days of oxygen therapy, more days of continuous positive airway pressure, and an increased prevalence of respiratory distress syndrome, patent ductus arteriosus, and sepsis. Conclusions: Couples who undergo IVF appear to be at increased risk of having low birth weight and preterm infants, and multiple gestations account for most of the neonatal morbidities. Both the mothers who conceive multiple gestations by means of IVF and their neonates are at an increased risk of having multiple morbidities. (J P EDIATR 1995;127:794-800)

Early morbidity and neurodevelopmental outcome in low-birthweight infants born after third trimester bleeding.

Neonatal mortality, morbidity, and neurodevelopmental sequelae were compared between a consecutive series of 77 liveborn, low-birthweight (less than 2500 g) infants delivered after third trimester bleeding and 154 appropriate control infants of similar gestational age. Infants born after abruptio placentae had lower Apgar scores at 1 minute and higher rates of acidosis in comparison with control infants. In multivariate analysis, the infants in this group had higher risks of severe intraventricular hemorrhage and poor outcome (neonatal death or cerebral palsy) in comparison with control infants. In placenta previa, the infants had a higher prevalence of respiratory distress syndrome, whereas unclassified antepartum bleeding was associated with a high rate of neonatal hypoglycemia. After adjustment, by logistic regression analysis, for the effect of confounding factors (gestational age, birthweight, social class, and education of the mother), the risk of minor infant neurodevelopmental abnormalities at 2-year follow-up was increased in infants delivered after total or partial placenta previa or after unclassified antepartum bleeding. Third trimester bleeding should be considered a strong risk factor for both short-term neonatal morbidity and subsequent infant neurodevelopmental impairment in the low-birthweight infant population.

The laboratory assessment of fetal lung maturity.

The assessment of fetal lung maturity by laboratory methods is reviewed, and the utility of the various approaches in the prediction of respiratory distress syndrome is discussed. Because of the relatively low prevalence of respiratory distress syndrome, methods with exceptionally high diagnostic sensitivity and specificity are required; such methods are rarely available for any diagnostic evaluation, and the methods with the greatest clinical acceptance in assessing fetal lung maturity have been those which require the most personnel time and skill. The consequences of laboratory testing in the environment of low prevalence diseases is discussed. Because of the clinical implications of an erroneous determination of fetal lung maturity, particularly in the case of incorrectly assessing the fetal lungs to be mature, a strong emotional overlay exists for accepting only the "reference method" or "gold standard" in this determination. This review briefly discusses the utility of commonly used methods in the context of the physical and chemical concepts. By reviewing the underlying principles of the methods, the origins of some of the frequently observed problems in this field are revealed. The emphasis is on practical application and issues of use both to clinician and laboratory in approaching this controversial and difficult area of assessment. It is demonstrated that there are several reasonably straightforward approaches which will provide appropriate clinical information more quickly, easily, and inexpensively than the methods generally requested.