Rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted respiratory distress syndrome with high sensitivity

Acta Paediatr. 2017 Mar;106(3):430-437. doi: 10.1111/apa.13683. Epub 2016 Dec 20.


Aim: Respiratory distress syndrome (RDS) is a major cause of mortality and morbidity in premature infants. By the time symptoms appear, it may already be too late to prevent a severe course, with bronchopulmonary dysplasia or mortality. We aimed to develop a rapid test of lung maturity for targeting surfactant supplementation.

Methods: Concentrations of the most surface-active lung phospholipid dipalmitoylphosphatidylcholine and sphingomyelin in gastric aspirates from premature infants were measured by mass spectrometry and expressed as the lecithin/sphingomyelin ratio (L/S). The same aspirates were analysed with mid-infrared spectroscopy. Subsequently, L/S was measured in gastric aspirates and oropharyngeal secretions from another group of premature infants using spectroscopy and the results were compared with RDS development. The 10-minute analysis required 10 μL of aspirate.

Results: An L/S algorithm was developed based on 89 aspirates. Subsequently, gastric aspirates were sampled in 136 infants of 24-31 weeks of gestation and 61 (45%) developed RDS. The cut-off value of L/S was 2.2, sensitivity was 92%, and specificity was 73%. In 59 cases, the oropharyngeal secretions had less valid L/S than gastric aspirate results.

Conclusion: Our rapid test for lung maturity, based on spectroscopy of gastric aspirate, predicted RDS with high sensitivity.

Keywords: Gastric aspirate; Lung surfactant; Mid-infrared spectroscopy; Prematurity; Respiratory distress syndrome.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Bodily Secretions / chemistry
  • Female
  • Humans
  • Infant, Newborn
  • Lung / growth & development*
  • Male
  • Phosphatidylcholines / analysis*
  • Phosphatidylcholines / metabolism
  • Respiratory Distress Syndrome, Newborn / diagnosis*
  • Sphingomyelins / analysis*
  • Sphingomyelins / metabolism


  • Phosphatidylcholines
  • Sphingomyelins

Supplementary concepts

  • Respiratory Distress Syndrome In Premature Infants