Korean J Perinatol.  2014 Dec;25(4):284-291. 10.14734/kjp.2014.25.4.284.

Serum Enzymes in Predicting Transient Tachypnea of Newborn and Respiratory Distress Syndrome

• An YS
• Kim IU
• Yang MY
• Jeong HR
• Kim HS

• KMID: 2281146
• DOI: http://doi.org/10.14734/kjp.2014.25.4.284

Abstract

PURPOSE
Perinatal asphyxia is a major factor correlated with diseases that cause respiratory distress in a neonate. So we aimed to investigate the relationship between respiratory distress syndrome (RDS) and transient tachypnea of newborn (TTN) with plasma biological markers of perinatal asphyxia in full-term neonates.
METHODS
Full-term neonates with transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) who were admitted within 24 hours after birth were enrolled in a study group. And control group are infants with premature rupture of amniotic membrane without significant findings. Serum lactate dehydrogenase (LDH), aspartate transaminase (AST), alanine transaminase (ALT), creatine kinase (CK) and myoglobin were measured at admission.
RESULTS
Of the total 80 infants, 54 were of the study group and 26 were of the control group. The numbers of RDS and TTN groups were 27 and 27, and the numbers of RDS with hypoxic-ischemic encephalopathy (HIE) and RDS without HIE were 6 and 21 retrospectively. Serum AST, ALT, LDH and CK were significantly higher in the study group than the control group (P<0.05). When RDS group and TTN group were compared AST and LDH were significantly higher in RDS group than TTN group (P<0.05). Serum AST, ALT and LDH were significantly higher in RDS with HIE group than RDS without HIE group (P<0.05). A prediction of RDS by LDH analysis showed good correlation by receiver operating characteristic curve (P<0.05). A cut off level of 720 IU/L for LDH was the best predictor of RDS (sensitivity 63% and specificity 86%).
CONCLUSION
LDH is an excellent predictor to differentiate RDS from TTN soon after birth in full-term neonates with respiratory distress.

Keyword

Respiratory distress syndrome; Transient tachypnea of the newborn; Lactate dehydrogenase; spartate transaminase; Neonate

MeSH Terms

Alanine Transaminase
Amnion
Aspartate Aminotransferases
Asphyxia
Biomarkers
Creatine Kinase
Humans
Hypoxia-Ischemia, Brain
Infant
Infant, Newborn
L-Lactate Dehydrogenase
Myoglobin
Parturition
Plasma
Retrospective Studies
ROC Curve
Rupture
Sensitivity and Specificity
Transient Tachypnea of the Newborn*
Alanine Transaminase
Aspartate Aminotransferases
Creatine Kinase
L-Lactate Dehydrogenase
Myoglobin

Figure

• 

  Fig. 1. Receiver operating characteristics (ROC) curve for lactate dehydrogenase (LDH) to discriminate respiratory distress syndrome among neonatal respiratory disease. An area under ROC curve for LDH is 0.765 (95% Confidence interval 0.63-0.89, P=0.001). A cut off level of 720 IU/L for LDH was the best predictor of RDS (sensitivity 63% and specificity 86%).

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