PREDICTION OF RESPIRATORY-DISTRESS SYNDROME BY THE NOVEL DIPALMITOYL PHOSPHATIDYLCHOLINE TEST

Objective: To determine the accuracy of a new test that measures the c oncentration in amniotic fluid (AF) of dipalmitoyl phosphatidylcholine (DPPC) in predicting respiratory distress syndrome (RDS). Methods: Th e neonatal respiratory status of 176 newborns delivered within 72 hour s of sampling was correlated with the concentration of DPPC, fluoresce nce polarization (TDx-FLM), lecithin-sphingomyelin ratio (US), and pho sphatidylglycerol (Amniostat-FLM) in AF. Results: Thirty infants devel oped RDS (17%), all correctly predicted with DPPC values less than 12 mu g/mL (sensitivity 100%). Only six of the 146 cases with no RDS had DPPC values less than 12 mu g/mL (specificity 96%). The overall accura cy of the DPPC test was 98% compared with 70% for TDx-FLM, 71% for the L/S, and 67% for Amniostat-FLM. Receiver operating characteristic ana lysis area was 0.98 +/- 0.01, indicating that the DPPC test is superio r to both the TDx-FLM and L/S tests. Conclusion: The DPPC test is an a ccurate predictor of RDS and fetal lung maturity.