Amniotic lamellar body count: predicting and distinguishing neonatal respiratory complications in twin pregnancies

Background: Twin pregnancies have a higher rate of preterm births, making precise prediction of neonatal respiratory disorders essential. We herein examined the amniotic lamellar body count (LBC) and found it to be an accurate predictor of respiratory disorders in twin pregnancies.

Methods: Five hundred fourteen amniotic fluid samples, comprising 132 dichorionic twin (DCT) and 125 monochorionic twin (MCT) gestations, were obtained at cesarean section performed at 29 to 38 gestational weeks. Samples were analyzed immediately without centrifugation.

Results: There were 26 neonates (5.1%) with respiratory distress syndrome (RDS) and 43 (8.4%) with transient tachypnea of the newborn (TTN). The LBC in neonates with TTN (5.12×10(4)/μl) was between the counts in RDS (1.26×10(4)/μl) and controls (10.6×10(4)/μl), which differed significantly. Twin concordance rates were significantly higher for TTN in MCT gestations than DCT gestations (p=0.003) and delta LBC value was significantly smaller in MCT (3.15±0.4×10(4)/μl) than DCT (5.17±0.5×10(4)/μl) gestations (p=0.003).

Conclusions: The amniotic LBC is useful for predicting respiratory disorders, including RDS and TTN, in twin pregnancies. The data in this study may indicate a genetic predisposition to TTN among MCTs.