Delayed appearance of pulmonary maturation markers is associated with poor glucose control in diabetic pregnancies

J. M. Piper, Elly M Xenakis, O. Langer

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Fetuses born after pregnancies complicated by diabetes display delayed pulmonary maturation as measured by the delayed appearance of biochemical indicators of pulmonary maturity (phosphatidylglycerol, lecithin/sphingomyelin ratio) and by the occurrence of hyaline membrane disease even in term gestations. We tested the hypothesis that poor maternal glycemic control is associated with delayed appearance of the biochemical markers of fetal pulmonary maturation. Consecutive diabetic pregnancies with documentation of maternal glycemic control and amniotic fluid analysis for PG were analyzed. Maternal glycemic control was defined as good if the mean blood glucose was ≤5.8 mmol/L (105 mg/dl) and poor if >5.8 mmol/L. The presence of amniotic fluid phosphatidylglycerol was considered an indicator of lung maturity. Hyaline membrane disease was defined by the criteria of Corbet et al. [J Pediatr 118:277-284, 1991]. A total of 621 diabetic pregnancies were analyzed (261 good glycemic control, 360 poor glycemic control). Phosphatidylglycerol was absent in 21% of good glycemic control vs. 31% of poor glycemic control pregnancies (P < 0.05). When stratified by gestational age, the risk of absence of phosphatidylglycerol was significantly higher in the poor glycemic control group (O.R. 1.83, 1.19- 2.84). At 36-37.9 weeks, poor glycemic control pregnancies had significantly higher rates of absent phosphatidylglycerol (37% vs. 22%, O.R. 2.04, 1.1- 3.9). All cases of hyaline membrane disease beyond 32 weeks gestation occurred in poor glycemic control pregnancies. There were no cases of hyaline membrane disease beyond 37.0 weeks gestation. We conclude that poorly controlled maternal glucose levels are associated with delayed appearance of phosphatidylglycerol in diabetic pregnancies. However, after 37.0 weeks of gestation, no significant neonatal pulmonary disease occurred.

Original languageEnglish (US)
Pages (from-to)148-153
Number of pages6
JournalJournal of Maternal-Fetal Medicine
Volume7
Issue number3
DOIs
StatePublished - 1998

Fingerprint

Pregnancy in Diabetics
Phosphatidylglycerols
Glucose
Pregnancy
Lung
Hyaline Membrane Disease
Mothers
Amniotic Fluid
Infant, Newborn, Diseases
Sphingomyelins
Lecithins
Documentation
Lung Diseases
Gestational Age
Blood Glucose
Fetus
Biomarkers

Keywords

  • Fetal lung maturity
  • Gestational diabetes
  • Phosphatidylglycerol

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

Delayed appearance of pulmonary maturation markers is associated with poor glucose control in diabetic pregnancies. / Piper, J. M.; Xenakis, Elly M; Langer, O.

In: Journal of Maternal-Fetal Medicine, Vol. 7, No. 3, 1998, p. 148-153.

Research output: Contribution to journalArticle

@article{c8ebc4620b8b442cb2e306b2c427754f,
title = "Delayed appearance of pulmonary maturation markers is associated with poor glucose control in diabetic pregnancies",
abstract = "Fetuses born after pregnancies complicated by diabetes display delayed pulmonary maturation as measured by the delayed appearance of biochemical indicators of pulmonary maturity (phosphatidylglycerol, lecithin/sphingomyelin ratio) and by the occurrence of hyaline membrane disease even in term gestations. We tested the hypothesis that poor maternal glycemic control is associated with delayed appearance of the biochemical markers of fetal pulmonary maturation. Consecutive diabetic pregnancies with documentation of maternal glycemic control and amniotic fluid analysis for PG were analyzed. Maternal glycemic control was defined as good if the mean blood glucose was ≤5.8 mmol/L (105 mg/dl) and poor if >5.8 mmol/L. The presence of amniotic fluid phosphatidylglycerol was considered an indicator of lung maturity. Hyaline membrane disease was defined by the criteria of Corbet et al. [J Pediatr 118:277-284, 1991]. A total of 621 diabetic pregnancies were analyzed (261 good glycemic control, 360 poor glycemic control). Phosphatidylglycerol was absent in 21{\%} of good glycemic control vs. 31{\%} of poor glycemic control pregnancies (P < 0.05). When stratified by gestational age, the risk of absence of phosphatidylglycerol was significantly higher in the poor glycemic control group (O.R. 1.83, 1.19- 2.84). At 36-37.9 weeks, poor glycemic control pregnancies had significantly higher rates of absent phosphatidylglycerol (37{\%} vs. 22{\%}, O.R. 2.04, 1.1- 3.9). All cases of hyaline membrane disease beyond 32 weeks gestation occurred in poor glycemic control pregnancies. There were no cases of hyaline membrane disease beyond 37.0 weeks gestation. We conclude that poorly controlled maternal glucose levels are associated with delayed appearance of phosphatidylglycerol in diabetic pregnancies. However, after 37.0 weeks of gestation, no significant neonatal pulmonary disease occurred.",
keywords = "Fetal lung maturity, Gestational diabetes, Phosphatidylglycerol",
author = "Piper, {J. M.} and Xenakis, {Elly M} and O. Langer",
year = "1998",
doi = "10.1002/(SICI)1520-6661(199805/06)7:3<148::AID-MFM9>3.0.CO;2-K",
language = "English (US)",
volume = "7",
pages = "148--153",
journal = "Journal of Maternal-Fetal Medicine",
issn = "1057-0802",
publisher = "Parthenon Publishing Group",
number = "3",

}

TY - JOUR

T1 - Delayed appearance of pulmonary maturation markers is associated with poor glucose control in diabetic pregnancies

AU - Piper, J. M.

AU - Xenakis, Elly M

AU - Langer, O.

PY - 1998

Y1 - 1998

N2 - Fetuses born after pregnancies complicated by diabetes display delayed pulmonary maturation as measured by the delayed appearance of biochemical indicators of pulmonary maturity (phosphatidylglycerol, lecithin/sphingomyelin ratio) and by the occurrence of hyaline membrane disease even in term gestations. We tested the hypothesis that poor maternal glycemic control is associated with delayed appearance of the biochemical markers of fetal pulmonary maturation. Consecutive diabetic pregnancies with documentation of maternal glycemic control and amniotic fluid analysis for PG were analyzed. Maternal glycemic control was defined as good if the mean blood glucose was ≤5.8 mmol/L (105 mg/dl) and poor if >5.8 mmol/L. The presence of amniotic fluid phosphatidylglycerol was considered an indicator of lung maturity. Hyaline membrane disease was defined by the criteria of Corbet et al. [J Pediatr 118:277-284, 1991]. A total of 621 diabetic pregnancies were analyzed (261 good glycemic control, 360 poor glycemic control). Phosphatidylglycerol was absent in 21% of good glycemic control vs. 31% of poor glycemic control pregnancies (P < 0.05). When stratified by gestational age, the risk of absence of phosphatidylglycerol was significantly higher in the poor glycemic control group (O.R. 1.83, 1.19- 2.84). At 36-37.9 weeks, poor glycemic control pregnancies had significantly higher rates of absent phosphatidylglycerol (37% vs. 22%, O.R. 2.04, 1.1- 3.9). All cases of hyaline membrane disease beyond 32 weeks gestation occurred in poor glycemic control pregnancies. There were no cases of hyaline membrane disease beyond 37.0 weeks gestation. We conclude that poorly controlled maternal glucose levels are associated with delayed appearance of phosphatidylglycerol in diabetic pregnancies. However, after 37.0 weeks of gestation, no significant neonatal pulmonary disease occurred.

AB - Fetuses born after pregnancies complicated by diabetes display delayed pulmonary maturation as measured by the delayed appearance of biochemical indicators of pulmonary maturity (phosphatidylglycerol, lecithin/sphingomyelin ratio) and by the occurrence of hyaline membrane disease even in term gestations. We tested the hypothesis that poor maternal glycemic control is associated with delayed appearance of the biochemical markers of fetal pulmonary maturation. Consecutive diabetic pregnancies with documentation of maternal glycemic control and amniotic fluid analysis for PG were analyzed. Maternal glycemic control was defined as good if the mean blood glucose was ≤5.8 mmol/L (105 mg/dl) and poor if >5.8 mmol/L. The presence of amniotic fluid phosphatidylglycerol was considered an indicator of lung maturity. Hyaline membrane disease was defined by the criteria of Corbet et al. [J Pediatr 118:277-284, 1991]. A total of 621 diabetic pregnancies were analyzed (261 good glycemic control, 360 poor glycemic control). Phosphatidylglycerol was absent in 21% of good glycemic control vs. 31% of poor glycemic control pregnancies (P < 0.05). When stratified by gestational age, the risk of absence of phosphatidylglycerol was significantly higher in the poor glycemic control group (O.R. 1.83, 1.19- 2.84). At 36-37.9 weeks, poor glycemic control pregnancies had significantly higher rates of absent phosphatidylglycerol (37% vs. 22%, O.R. 2.04, 1.1- 3.9). All cases of hyaline membrane disease beyond 32 weeks gestation occurred in poor glycemic control pregnancies. There were no cases of hyaline membrane disease beyond 37.0 weeks gestation. We conclude that poorly controlled maternal glucose levels are associated with delayed appearance of phosphatidylglycerol in diabetic pregnancies. However, after 37.0 weeks of gestation, no significant neonatal pulmonary disease occurred.

KW - Fetal lung maturity

KW - Gestational diabetes

KW - Phosphatidylglycerol

UR - http://www.scopus.com/inward/record.url?scp=0031781897&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031781897&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1520-6661(199805/06)7:3<148::AID-MFM9>3.0.CO;2-K

DO - 10.1002/(SICI)1520-6661(199805/06)7:3<148::AID-MFM9>3.0.CO;2-K

M3 - Article

C2 - 9642613

AN - SCOPUS:0031781897

VL - 7

SP - 148

EP - 153

JO - Journal of Maternal-Fetal Medicine

JF - Journal of Maternal-Fetal Medicine

SN - 1057-0802

IS - 3

ER -