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Amniotic fluid lamellar body concentration as a marker of fetal lung maturity at term elective caesarean delivery
Author(s) -
WALKER Susan P.,
CHOW Yvonne Y. C.,
UGONI Antoni M.,
HOLBERTON James R.,
SMITH Carole L.,
PERMEZEL Michael J.
Publication year - 2010
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2010.01199.x
Subject(s) - amniotic fluid , elective caesarean section , medicine , lamellar granule , obstetrics , caesarean delivery , fetus , lung , maturity (psychological) , caesarean section , pregnancy , biology , psychology , genetics , developmental psychology
Background: Caesarean birth, without prior labour, is associated with an increased risk of neonatal respiratory morbidity among term infants. The concentration of lamellar bodies in amniotic fluid reflects pulmonary surfactant production and release, and is thus used in preterm populations as a marker of fetal lung maturity. Whether amniotic fluid lamellar body concentration (AFLBC) may correlate with risk factors for term respiratory distress has not previously been evaluated. Aims: To determine the relationship between AFLBC and risk factors for respiratory distress following term caesarean birth. Methods: The AFLBC of 249 women at the time of term caesarean birth was examined for an association with gestational age, gender, presentation and neonatal respiratory distress requiring special care nursery (SCN) admission. Results: There was a significant increase in AFLBC with gestation. When compared with caesarean deliveries performed during the 37th week of gestation, there was a 50%, 54% and 56% increase in lamellar body concentrations (LBCs) taken during the 38th, 39th and 40th week of gestation respectively ( P < 0.05 for all). Female fetuses had a 16% higher LBC than males ( P < 0.05). An LBC <100 × 10 9 mL −1 was associated with increased risk of admission to the SCN with respiratory distress (RR = 5.6; 1.2–26.5, P < 0.05). Conclusion: Known risk factors for term respiratory distress are reflected in the AFLBC. A significant relationship exists between AFLBC and respiratory morbidity following term caesarean birth. However, the low prevalence of this condition limits the clinical role of AFLBC as a predictive test for term respiratory morbidity.