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Restiratorv Distress Svndrome in Infants of Diabetic Mothers in the 1980s

No Direct Adverse Effect of Maternal Diabetes With Modern Management

From the Division of Neonatology, Departments of Pediatrics, Obstetrics arid Gynecology, internal Medicine, and the Division of Epidermiology and Statistics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

The purpose of this study was to test the hypothesis that diabetes in pregnancy in the 1980s no longer represents a direct risk factor for the development of respiratory distress syndrome (RDS) independent of gestational age, race, sex, mode of delivery, and neonatal asphyxia. We pair-matched 127 infants of diabetic mothers (diabetic group) with 127 infants of nondiabetic mothers (controls) for the above factors. Diabetic mothers enrolled before nine weeks' gestation were randomly assigned to one of two groups: I. "strict management," to achieve euglycemic (fasting blood glucose less than 80 mg/dL, 1.5-hour-postprandial blood glucose less than 120 mg/dL); 11. "customary management," to provide care "as practiced in the community" (fasting blood glucose 100 mg/dL or less, postprandial blood glucose less than 140 mg/dL). A group enrolled after the first trimes- ter (111) was managed identically to group 11. Infants of diabetic mothers had a rate of RDS of 13.4%, not significantly different from the rate of 15% in controls ( P > .05). When analyzed by gestational age groups of less than 36, or 36 or more weeks' gestation, there was also no difference in frequency of RDS between the diabetic group and controls. By logistic regression analysis, the presence of RDS in infants of diabetic mothers significantly correlated with lower gestational age (P < .0001), and delivery by cesarean section not preceded by labor ( P < .01). We conclude that: 1) Diabetes during pregnancy as currently managed is not a direct risk factor for the development of neonatal RDS, and 2) Premature deliveries and cesarean section deliveries not preceded by labor may increase the frequency of RDS in infants of diabetic mothers. (Obstet Gynecol 69:191, 1987)

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				L. Cordero, S. H. Treuer, M. B. Landon, and S. G. Gabbe Management of Infants of Diabetic Mothers Arch Pediatr Adolesc Med, March 1, 1998; 152(3): 249 - 254. [Abstract] [Full Text] [PDF]