The accuracy of lamellar body count and lecithin/sphingomyelin ratio in the prediction of neonatal respiratory distress syndrome: a meta-analysis

Objective To compare the performance of the lecithin/sphingomyelin ratio an d the lamellar body count in the prediction of neonatal respiratory distres s syndrome. Design Meta-analysis. Sample Six studies reporting on the performance of both the lecithin/sphing omyelin ratio and the lamellar body count published between January 1966 an d August 1999. Methods We performed a computerised MEDLINE search to identify articles pub lished on the subject. For the six selected studies, prevalence of respirat ory distress syndrome and sensitivity and specificity of the tests in the p rediction of respiratory distress syndrome were calculated, and overall per formance was assessed by constructing summary receiver-operating characteri stic curves. Results The constructed summary receiver-operating characteristic curves sh owed the lamellar body count to perform slightly better than the lecithin/s phingomyelin ratio in the prediction of respiratory distress syndrome (P = 0.13). Conclusions Since the lamellar body count can be pet-formed quickly and sin ce it is less expensive than the lecithin/sphingomyelin ratio, we recommend the former as the test of first choice in the assessment of fetal lung mat urity.