Taehan Sanbuinkwa Hakhoe chapchi; Korean journal of obstetrics and gynecology; 대한산부인과학회잡지
Objective : Our purpose is to determine the optimal cutoff value for the TDx-FLM assay for predicting fetal lung maturity and its clinical efficiency.
Performed from 1996 through 2000 at Ajou University Hospital. All were delivered between 28 and 37 weeks´ gestation. Women treated with steroids after fetal lung maturity test were excluded in this study. In neonatal respiratory outcomes, result of fetal lung maturity was defined as neonates who were not affected by respiratory distress syndrome (RDS). All neonates were divided into mature and immature group according to their respiratory outcomes and clinical characteristics of both groups were evaluated. The predictive values for
manurity and immaturity were calculated as previously defined.
Results : Among 117 newboms, RDS developed in 8 cases (immature group), and 109 cases were unaffected (mature group). In mature and immature group, mean gestational age was 35.0 weeks and 33.1 weeks (p=0.038), mean fetal birth weight 2313.4 gm and 2036.3 gm respectively (p=0.279). Preterm deliveries
were due preterm labor (32.1% vs 25.0%, p=0.676), premature rupture of membranes (11.9% vs 12.5% p=0.962), preeclamsia (17.4% vs 37.5%, p=0.384), intrauterine growth restriction (11.0% vs 0%, p=0.211),
discordant twin (16.5% vs 0%, p=0.212) and other maternal complications (35.8% vs 37.5%, p=0.922) And also, frequencies of twin were 0% vs 64.2% (p＜0.001), gestational diabetes 3.7% vs 12.5% p=0.233), steroid usage 67.0% vs 12.5% (p=0.002), and median TDx-FLM level 59.2 mg/g (range 13.8 - 120.4 mg/g) vs 13.1 mg/g (range 1.20-27.9 mg/g) (p=0.004). The best cutoff point to calculate predictive value for a mature result was ≥24.7 mg/g which gave a sensitivity 93.6%, specificity 87.5%, positive predictive value (PPV) 99.0%,
negative predictive value (NPV) 50.0% and efficiency 93.1.
Conclusion : The best cutoff value of TDx-FLM levels for assessment of fetal lung maturation was 24.7 mg/g in our study group.
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