Optimal thresholds of the lecithin/sphingomyelin ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol in diabetic women

A. Ghidini, C. Y. Spong, K. Goodwin, J. C. Pezzullo

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To assess the optimal thresholds of the lecithin/sphingomyelin (L/S) ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol (PG) in diabetic pregnant women. Methods: We accessed a database of clear amniotic fluid specimens obtained by transabdominal amniocentesis in diabetic women with singleton non-malformed fetuses. PG results were classified as 'absent' or 'present'. Receiver operating characteristic (ROG) curve analysis was constructed of different L/S ratios and lamellar body counts to identify the optimal threshold for prediction of the presence of PG. Sensitivity was defined as the rate of L/S ratio and lamellar body count above specific thresholds among cases with present PG. The false-positive rate was that of L/S ratios or lamellar body counts above specific thresholds among cases with absent PG. Statistical analysis included one-way analysis of variance with post-hoc analysis, with p < 0.05 considered significant. Results: A total of 76 consecutive women were inclucled in the analysis, 74% (n = 56) using insulin and the remainder treated by diet alone. L/S and PG results were both available in 72 women. PG was reported as 'present' in 70% (51/73) of specimens. As expected, there was a significant relationship between L/S ratios and presence of PG (area under the curve = 0.932, p < 0.001). An L/S ratio of ≥ 3.0 represented the optimal trade-off between sensitivity (68%) and false-positive rate (6%) in the prediction of present PG. Similarly, there was a significant relationship between lamellar body count values and presence of PG (area under the curve = 0.976, p < 0.001). A lamellar body count of ≥ 50 000 represented the optimal trade-off between sensitivity (92%) and false-positive rate (0%) in the prediction of present PG. Conclusion: In diabetic pregnant patients, the presence of PG in the amniotic fluid more closely corresponded to an L/S ratio of ≥ 3.0 or to a lamellar body count of ≥ 50 000.

Original languageEnglish (US)
Pages (from-to)95-98
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume12
Issue number2
DOIs
StatePublished - Aug 2002
Externally publishedYes

Fingerprint

Phosphatidylglycerols
Sphingomyelins
Lecithins
Amniotic Fluid
Area Under Curve
Amniocentesis
ROC Curve
Pregnant Women
Analysis of Variance
Fetus

Keywords

  • Diabetes in pregnancy
  • Fetal lung maturity test
  • Lecithin/sphingomyelin ratio
  • Phosphatidyl glycerol

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

@article{fe1d0cbc28a54c628127fb76c4fa4ecf,
title = "Optimal thresholds of the lecithin/sphingomyelin ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol in diabetic women",
abstract = "Objective: To assess the optimal thresholds of the lecithin/sphingomyelin (L/S) ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol (PG) in diabetic pregnant women. Methods: We accessed a database of clear amniotic fluid specimens obtained by transabdominal amniocentesis in diabetic women with singleton non-malformed fetuses. PG results were classified as 'absent' or 'present'. Receiver operating characteristic (ROG) curve analysis was constructed of different L/S ratios and lamellar body counts to identify the optimal threshold for prediction of the presence of PG. Sensitivity was defined as the rate of L/S ratio and lamellar body count above specific thresholds among cases with present PG. The false-positive rate was that of L/S ratios or lamellar body counts above specific thresholds among cases with absent PG. Statistical analysis included one-way analysis of variance with post-hoc analysis, with p < 0.05 considered significant. Results: A total of 76 consecutive women were inclucled in the analysis, 74{\%} (n = 56) using insulin and the remainder treated by diet alone. L/S and PG results were both available in 72 women. PG was reported as 'present' in 70{\%} (51/73) of specimens. As expected, there was a significant relationship between L/S ratios and presence of PG (area under the curve = 0.932, p < 0.001). An L/S ratio of ≥ 3.0 represented the optimal trade-off between sensitivity (68{\%}) and false-positive rate (6{\%}) in the prediction of present PG. Similarly, there was a significant relationship between lamellar body count values and presence of PG (area under the curve = 0.976, p < 0.001). A lamellar body count of ≥ 50 000 represented the optimal trade-off between sensitivity (92{\%}) and false-positive rate (0{\%}) in the prediction of present PG. Conclusion: In diabetic pregnant patients, the presence of PG in the amniotic fluid more closely corresponded to an L/S ratio of ≥ 3.0 or to a lamellar body count of ≥ 50 000.",
keywords = "Diabetes in pregnancy, Fetal lung maturity test, Lecithin/sphingomyelin ratio, Phosphatidyl glycerol",
author = "A. Ghidini and Spong, {C. Y.} and K. Goodwin and Pezzullo, {J. C.}",
year = "2002",
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doi = "10.1080/jmf.12.2.95.98",
language = "English (US)",
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pages = "95--98",
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issn = "1476-7058",
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}

TY - JOUR

T1 - Optimal thresholds of the lecithin/sphingomyelin ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol in diabetic women

AU - Ghidini, A.

AU - Spong, C. Y.

AU - Goodwin, K.

AU - Pezzullo, J. C.

PY - 2002/8

Y1 - 2002/8

N2 - Objective: To assess the optimal thresholds of the lecithin/sphingomyelin (L/S) ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol (PG) in diabetic pregnant women. Methods: We accessed a database of clear amniotic fluid specimens obtained by transabdominal amniocentesis in diabetic women with singleton non-malformed fetuses. PG results were classified as 'absent' or 'present'. Receiver operating characteristic (ROG) curve analysis was constructed of different L/S ratios and lamellar body counts to identify the optimal threshold for prediction of the presence of PG. Sensitivity was defined as the rate of L/S ratio and lamellar body count above specific thresholds among cases with present PG. The false-positive rate was that of L/S ratios or lamellar body counts above specific thresholds among cases with absent PG. Statistical analysis included one-way analysis of variance with post-hoc analysis, with p < 0.05 considered significant. Results: A total of 76 consecutive women were inclucled in the analysis, 74% (n = 56) using insulin and the remainder treated by diet alone. L/S and PG results were both available in 72 women. PG was reported as 'present' in 70% (51/73) of specimens. As expected, there was a significant relationship between L/S ratios and presence of PG (area under the curve = 0.932, p < 0.001). An L/S ratio of ≥ 3.0 represented the optimal trade-off between sensitivity (68%) and false-positive rate (6%) in the prediction of present PG. Similarly, there was a significant relationship between lamellar body count values and presence of PG (area under the curve = 0.976, p < 0.001). A lamellar body count of ≥ 50 000 represented the optimal trade-off between sensitivity (92%) and false-positive rate (0%) in the prediction of present PG. Conclusion: In diabetic pregnant patients, the presence of PG in the amniotic fluid more closely corresponded to an L/S ratio of ≥ 3.0 or to a lamellar body count of ≥ 50 000.

AB - Objective: To assess the optimal thresholds of the lecithin/sphingomyelin (L/S) ratio and lamellar body count for the prediction of the presence of phosphatidyl glycerol (PG) in diabetic pregnant women. Methods: We accessed a database of clear amniotic fluid specimens obtained by transabdominal amniocentesis in diabetic women with singleton non-malformed fetuses. PG results were classified as 'absent' or 'present'. Receiver operating characteristic (ROG) curve analysis was constructed of different L/S ratios and lamellar body counts to identify the optimal threshold for prediction of the presence of PG. Sensitivity was defined as the rate of L/S ratio and lamellar body count above specific thresholds among cases with present PG. The false-positive rate was that of L/S ratios or lamellar body counts above specific thresholds among cases with absent PG. Statistical analysis included one-way analysis of variance with post-hoc analysis, with p < 0.05 considered significant. Results: A total of 76 consecutive women were inclucled in the analysis, 74% (n = 56) using insulin and the remainder treated by diet alone. L/S and PG results were both available in 72 women. PG was reported as 'present' in 70% (51/73) of specimens. As expected, there was a significant relationship between L/S ratios and presence of PG (area under the curve = 0.932, p < 0.001). An L/S ratio of ≥ 3.0 represented the optimal trade-off between sensitivity (68%) and false-positive rate (6%) in the prediction of present PG. Similarly, there was a significant relationship between lamellar body count values and presence of PG (area under the curve = 0.976, p < 0.001). A lamellar body count of ≥ 50 000 represented the optimal trade-off between sensitivity (92%) and false-positive rate (0%) in the prediction of present PG. Conclusion: In diabetic pregnant patients, the presence of PG in the amniotic fluid more closely corresponded to an L/S ratio of ≥ 3.0 or to a lamellar body count of ≥ 50 000.

KW - Diabetes in pregnancy

KW - Fetal lung maturity test

KW - Lecithin/sphingomyelin ratio

KW - Phosphatidyl glycerol

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