Changes in the threshold of fetal lung maturity testing and neonatal outcome of infants delivered electively before 39 weeks gestation: implications and cost-effectiveness

被引:4
|
作者
Ventolini, G.
Neiger, R.
Hood, D. L.
Belcastro, M. R.
机构
[1] Wright State Univ, Dept Obstet & Gynecol, Dayton, OH 45409 USA
[2] Wright State Univ, Dept Pathol, Dayton, OH 45409 USA
[3] Wright State Univ, Dept Neonatol, Dayton, OH 45409 USA
关键词
neonatal; elective delivery; fetal lung maturity;
D O I
10.1038/sj.jp.7211501
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To compare the neonatal outcome of infants delivered before 39 weeks' gestation following documentation of fetal lung maturity before and after the lamellar body count (LBC) threshold was increased from 30 000 to 50 000 LB/ul. We discuss the algorithm employed for testing fetal lung maturity, the cost of testing and potential savings. Material and methods: We studied the outcome of infants delivered electively before 39 weeks' gestation after fetal lung maturity was documented by amniotic fluid analysis. We compared the outcome of neonates born before and after the LBC threshold was increased. Results: Our cohort included 527 neonates who were divided into two groups: 264 who underwent fetal lung maturity studies before the change in LBC threshold and 263 who underwent testing after the change. In the first group, 158 neonates met the criteria of LBC > 30 000 LB/ul and were delivered without further testing. The second group included 154 neonates who were mature by LBC > 50 000 LB/ul and were delivered. Seven of the neonates born in the first group required admission to the neonatal intensive care unit ( NICU), whereas in the second group only two neonates required admission ( P = 0.02). Additionally, 16 neonates in the first group required respiratory assistance compared with six in the second group ( P = 0.04). The overall neonatal complication rate was significantly higher in the first group ( P = 0.001). Conclusion: Changing the LBC threshold resulted in a significant decrease in neonatal morbidity. Employing the algorithm, we described for testing fetal lung maturity is cost effective, and more importantly, represents sound evidence-based medical management.
引用
收藏
页码:264 / 267
页数:4
相关论文
共 9 条
  • [1] Changes in the threshold of fetal lung maturity testing and neonatal outcome of infants delivered electively before 39 weeks gestation: implications and cost-effectiveness
    G Ventolini
    R Neiger
    D L Hood
    M R Belcastro
    Journal of Perinatology, 2006, 26 : 264 - 267
  • [2] Fetal lung maturity testing before 39 weeks and neonatal outcomes
    Bates, E.
    Rouse, D.
    Chapman, V.
    Mann, M. L.
    Carlo, W.
    Tita, A.
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2009, 201 (06) : S17 - S17
  • [3] Neonatal Outcomes After Demonstrated Fetal Lung Maturity Before 39 Weeks of Gestation
    Jelsema, Russ
    OBSTETRICS AND GYNECOLOGY, 2011, 117 (05): : 1228 - 1229
  • [4] Neonatal Outcomes After Demonstrated Fetal Lung Maturity Before 39 Weeks of Gestation
    Bates, Elizabeth
    Rouse, Dwight J.
    Mann, Merry Lynn
    Chapman, Victoria
    Carlo, Waldemar A.
    Tita, Alan T. N.
    OBSTETRICS AND GYNECOLOGY, 2010, 116 (06): : 1288 - 1295
  • [5] Neonatal Outcomes After Demonstrated Fetal Lung Maturity Before 39 Weeks of Gestation Reply
    Bates, Elizabeth
    Rouse, Dwight
    Tita, Alan
    OBSTETRICS AND GYNECOLOGY, 2011, 117 (05): : 1229 - 1229
  • [6] Cost-effectiveness of fetal lung maturity testing in preterm labor
    Myers, ER
    Alvarez, JG
    Richardson, DK
    Ludmir, J
    OBSTETRICS AND GYNECOLOGY, 1997, 90 (05): : 824 - 829
  • [7] Perinatal HIV transmission and the cost-effectiveness of screening at 14 weeks gestation, at the onset of labour and the rapid testing of infants
    Udeh, Belinda
    Udeh, Chiedozie
    Graves, Nicholas
    BMC INFECTIOUS DISEASES, 2008, 8 (1)
  • [8] Perinatal HIV transmission and the cost-effectiveness of screening at 14 weeks gestation, at the onset of labour and the rapid testing of infants
    Belinda Udeh
    Chiedozie Udeh
    Nicholas Graves
    BMC Infectious Diseases, 8
  • [9] Fetal monitoring indications for delivery and 2-year outcome in 310 infants with fetal growth restriction delivered before 32 weeks' gestation in the TRUFFLE study
    Visser, G. H. A.
    Bilardo, C. M.
    Derks, J. B.
    Ferrazzi, E.
    Fratelli, N.
    Frusca, T.
    Ganzevoort, W.
    Lees, C. C.
    Napolitano, R.
    Todros, T.
    Wolf, H.
    Hecher, K.
    ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2017, 50 (03) : 347 - 352