Wijnberger L D E, de Kleine M, Voorbij H A M, Arabin B, van de Leur J J C M, Bruinse H W, Visser G H A, Bossuyt P M M, Mol B W J
Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands.
J Matern Fetal Neonatal Med. 2003 Dec;14(6):373-82. doi: 10.1080/14767050412331312210.
To study the changes in the lecithin/sphingomyelin (L/S) ratio and lamellar body count (LBC) during pregnancy and to study the effect of clinical characteristics on these measurements.
We reviewed in retrospect the amniotic fluid samples for the assessment of fetal lung maturity of consecutive women between January 1996 and December 2000. We evaluated the effect of antenatal administration of glucocorticoids, the presence of diabetes, fetal growth restriction and the amount of amniotic fluid on the L/S ratio and LBC. We then constructed normal curves, by relating the L/S ratio and LBC to gestational age in the cases without respiratory distress syndrome (RDS). Data from the literature were added to these curves.
From the 334 included women, 64 infants (19%) developed RDS. The LBC was lower in women with polyhydramnios (p = 0.04), and similar in women with oligohydramnios. Administration of glucocorticoids, the presence of maternal diabetes or fetal growth restriction did not affect the L/S ratio or the LBC. The median L/S ratio in cases without RDS showed a constant increase from a gestational age of 28 weeks onwards. The median LBC increased slowly between a gestational age of 28 weeks and 34 weeks, to increase more steeply thereafter.
The amount of amniotic fluid affects the LBC, but not the L/S ratio. Since the L/S ratio and the LBC increase with gestation, differences in gestational age should be taken into account in the interpretation of these fetal lung maturity tests.
研究孕期卵磷脂/鞘磷脂（L/S）比值和板层小体计数（LBC）的变化，并研究临床特征对这些测量值的影响。
我们回顾性分析了1996年1月至2000年12月期间连续孕妇的羊水样本，以评估胎儿肺成熟度。我们评估了产前使用糖皮质激素、糖尿病的存在、胎儿生长受限和羊水量对L/S比值和LBC的影响。然后，在无呼吸窘迫综合征（RDS）的病例中，通过将L/S比值和LBC与孕周相关联，构建了正常曲线。将文献数据添加到这些曲线上。
在纳入的334名女性中，64名婴儿（19%）发生了RDS。羊水过多的女性LBC较低（p = 0.04），羊水过少的女性LBC相似。使用糖皮质激素、母亲患有糖尿病或胎儿生长受限均不影响L/S比值或LBC。无RDS病例的L/S比值中位数从孕28周起持续增加。LBC中位数在孕28周至34周之间缓慢增加，此后增加更为陡峭。
羊水量影响LBC，但不影响L/S比值。由于L/S比值和LBC随孕周增加，在解释这些胎儿肺成熟度测试时应考虑孕周差异。
