Ultrasound image patterns right after birth can predict healthy neonates
-- a nested case-control study
Abstract
Abstract Purpose To distinguish healthy infants from potential lung
disease patients immediately after birth using lung ultrasound (LUS).
Design, Setting and Patients This is a nested case-control study
containing 22 lung disease patients and 473 healthy infants from a total
of 504 consecutive infants. The infants were admitted to the Obstetrics
& Gynecology Hospital of Fudan University, Shanghai, China, from 1
January 2020 to 1 April 2020. A newly designed scanning protocol was
used to capture LUS images. The sensitivity, specificity, PPV and NPV
for predicting healthy infants and patients were calculated
individually. The transition process image patterns and their variations
are shown. The relationship between clinical signs and high-risk image
patterns was calculated by Kendall’s tau-b test. Measurements and main
results LUS images were captured, and their predictive value was
calculated. Four low-risk patterns could typically be seen only in
healthy infants (specificity=86.4%, PPV=99.0%), whereas four high-risk
patterns could be seen in both healthy infants and patients
(specificity=62.4%, PPV=9.6%). High-risk patterns were more likely to
be pathological signs when appearing at the oxter and lower back and
physiological signs when appearing at the prothorax. These high-risk
patterns are significantly related to clinical signs. All these patterns
are consistent during the first 6 hours after birth. Conclusions LUS is
a valid modality for differentiating healthy infants from potential
patients with mild respiratory difficulty. Four low-risk patterns had
high value in predicting healthy infants, but four high-risk patterns
were not specific enough to discover lung disease patients.