Document Detail

Postmortem lung weight/body weight standards for term and preterm infants.
MedLine Citation:
PMID:  16161157     Owner:  NLM     Status:  MEDLINE    
Assessment of lung development is a crucial component of the perinatal autopsy, especially in preterm infants. In current pathology practice, the diagnosis of lung hypoplasia in very premature infants (<28 weeks of gestation) is based on a lung weight/body weight ratio (LW/BW) of 1.5% or less. While useful to confirm the presence of marked pulmonary hypoplasia, the 1.5% threshold may be too stringent to detect more subtle degrees of pulmonary hypoplasia, as seen in association with rupture of membranes. The aim of this study was to establish reference values for postmortem LW/BW in preterm and term infants. To this end, we performed a retrospective analysis of fetuses and newborns (16-41 weeks of gestation) without known risk factors for pulmonary hypoplasia. Mean LW/BW ranged between 2.98-3.15% between 16-27 weeks, and decreased to 2.55% by 28-36 weeks and 1.79% at term. The 10th percentile for LW/BW was significantly higher in preterm infants (2.24% between 20-23 weeks, and 2.59% between 24-27 weeks) than in term infants (1.24% at >or=37 weeks, P < 0.01). We then correlated LW/BW of infants with risk factors for pulmonary hypoplasia with the newly established reference values. As expected, mean LW/BW of infants with congenital diaphragmatic hernia or severe renal anomalies was <1.5% (0.98% and 1.40%, respectively). Mean LW/BW of infants with prolonged (> 1 week) rupture of membranes (PROM) was 2.08%. Three of 12 (25%) preterm infants with PROM had pulmonary hypoplasia according to the traditional criteria (LW/BW <1.5%). However, an additional 4/12 (33%) infants with PROM had a LW/BW between 1.5% and the 10th percentile for age (2.2%), indicative of more subtle but potentially relevant pulmonary underdevelopment. In conclusion, we determined LW/BW reference values for preterm and term infants. Correlation of LW/BW with age-matched reference values at postmortem examination represents an invaluable additional tool to evaluate lung growth, particularly in preterm infants.
Monique E De Paepe; Rebecca M Friedman; Fusun Gundogan; Halit Pinar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  40     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-03     Completed Date:  2006-03-16     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-8     Citation Subset:  IM    
Copyright Information:
(c) 2005 Wiley-Liss, Inc.
Department of Pathology, Women and Infants Hospital and Brown University Medical School, Providence, Rhode Island 02905, USA.
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MeSH Terms
Body Weight*
Fetal Membranes, Premature Rupture / pathology
Fetal Organ Maturity
Gestational Age
Hernia, Diaphragmatic / congenital,  pathology
Infant, Newborn*
Infant, Premature*
Kidney / abnormalities,  pathology
Lung / embryology,  pathology*
Organ Size*
Reference Values
Retrospective Studies
Risk Factors
Sex Factors

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