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Endocrine maturation and lung function in premature neonates of women with diabetes
C R Parker1, J C Hauth, G D Hankins
1Department of Obstetrics and Gynecology, University of Alabama, Birmingham 35294.
Insights
Infants born to mothers with diabetes may experience hormonal deficiencies, leading to respiratory distress syndrome. Poor diabetic control during pregnancy is linked to delayed fetal endocrine and lung maturation.
Area of Science:
- Endocrinology
- Neonatology
- Perinatology
Background:
- Respiratory distress syndrome (RDS) in premature infants can be linked to fetal hormonal deficiencies.
- Maternal diabetes is a known risk factor for adverse neonatal outcomes, including respiratory complications.
Purpose of the Study:
- To investigate the endocrine milieu in premature infants born to mothers with diabetes.
- To determine if specific hormone levels correlate with the development of respiratory distress syndrome in these neonates.
Main Methods:
- Studied 28 premature infants (34-37 weeks gestation) born to mothers with diabetes.
- Measured umbilical serum concentrations of estrone, estradiol, estriol, cortisol, and prolactin.
- Analyzed maternal plasma glucose levels and amniotic fluid lecithin-sphingomyelin ratios.
Main Results:
- Infants who developed RDS had lower serum concentrations of key hormones compared to those with normal lung function.
- Maternal plasma glucose levels were highest in women whose neonates developed RDS.
- An inverse correlation was observed between maternal glucose levels and fetal lung maturity markers.
Conclusions:
- Maternal diabetes can lead to delayed fetal endocrine milieu maturation, increasing the risk of respiratory distress syndrome.
- The extent of diabetic control during pregnancy appears to influence both fetal endocrine and lung maturation.
- Hormonal deficiencies in infants of diabetic mothers may play a significant role in the pathogenesis of RDS.
Abstract:
Because respiratory distress syndrome may result, in part, from a hormonal deficiency in the developing fetus, we investigated the endocrine millieu of 28 infants of women with diabetes who were delivered prematurely (34 to 37 weeks of gestation). The umbilical serum concentrations of estrone, estradiol, estriol, cortisol, and prolactin in infants of women with diabetes who developed respiratory distress syndrome (n = 6) were lower than those in infants of women with diabetes who had normal lung function. Serum hormone levels in age-matched newborns of normal women were higher than those in the infants of women with diabetes with respiratory distress syndrome but were not different than those in the infants of women with diabetes with normal lung function. Plasma glucose levels were highest in women whose neonates developed respiratory distress syndrome. An inverse correlation existed between maternal glucose levels and lecithin-sphingomyelin ratios in amniotic fluid. Thus diabetes occasionally results in significantly delayed maturation of the fetal endocrine milieu. In these instances, delayed fetal lung maturation is a frequent occurrence. Moreover, both phenomena may be related to the extent of diabetic control during pregnancy.