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Review
. 2019 May 31:5:100059.
doi: 10.1016/j.eurox.2019.100059. eCollection 2020 Jan.

Diagnostic accuracy of lamellar body count as a predictor of fetal lung maturity: A systematic review and meta-analysis

Ahmed Mahmoud Abdou  1 , Mohammad S Badr  1 , Khaled F Helal  1 , Mohamed E Rafeek  1 , Amr A Abdelrhman  1 , Mahmoud Kotb  1
Affiliations
Review

Diagnostic accuracy of lamellar body count as a predictor of fetal lung maturity: A systematic review and meta-analysis

Ahmed Mahmoud Abdou et al. Eur J Obstet Gynecol Reprod Biol X. .

Abstract

Objective: This study aimed to synthesize evidence from published studies about the diagnostic accuracy of lamellar body count (LBC) as a predictor of fetal lung maturity.

Study design: We searched Medline (via PubMed), EBSCO, Web of Science, Scopus and the Cochrane Library for relevant published studies assessing the accuracy of LBC as a predictor of fetal lung maturity. Studies were classified according to the counting essays, centrifugation protocols, and the reported optimum cut off values. Data of the true positive, true negative, false positive, and false negative were extracted and analyzed to calculate the overall sensitivity and specificity of the LBC.

Results: Thirty-one studies were included in the final analysis. Fourteen studies reported data for centrifuged amniotic fluid (AF) samples, 13 studies reported data for uncentrifuged samples, and four studies did not have enough information about whether centrifugation was done. LBC showed an area under the curve >80% in diagnosing lung immaturity with variable cut off values. Pooled analysis showed that LBC a 100% specificity to exclude respiratory distress syndrome (RDS) at a cut off value of 15,000 and 100% sensitivity to diagnose RDS at a cut off value of 55,000.

Conclusion: Cases with LBC < 15,000 are considered to have lung immaturity while cases with LBC > 45,000 in centrifuged AF samples or >55,000 in uncentrifuged AF samples are likely to have mature lungs. Cases with LBC ranging between these maturity and immaturity limits should be considered for further evaluation by other lung maturity tests.

Keywords: Fetal lung maturity; Lamellar body count; Meta-analysis; Systematic review.

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Figures

Fig. 1
Fig. 1
The flow diagram of the literature search and study selection.
Fig. 2
Fig. 2
The SROC curve for the LBC at different cut-off points.
Fig. 3
Fig. 3
shows the forest plot of the sensitivity and specificity of LBC in predicting neonatal RDS.
See this image and copyright information in PMC

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