PHOSPHOLIPID CONCENTRATIONS IN AMNIOTIC FLUID FROM DIABETIC PREGNANT WOMEN

Abstract

Newborn infants of mothers with diabetes mellitus have a higher incidence of the respiratory distress syndrome /RDS/ than infants of nondiabetics of the same gestational age. The pulmonary surfactant system in diabetic pregnancies was investigated by quantitative analysis of lecithin and sphingomyelin in 104 samples of amniotic fluid from 65 diabetic patients. The phospholipid concentrations have been related to gestational age, the state of diabetes according to White's classification, and the development of RDS. There is statistically significant evidence of accelerated surfactant production in White classes D, F, from 34 to 37 weeks gestation. Classes A, B, C, have phospholipid concentrations not significantly different from a reference material. RDS occurred in 26% and was frequently associated with mature phospholipid concentrations. Mature lecithin concentrations or L/S ratios are therefore no guarantee against RDS. There was a significant correlation between low Apgar scores and subsequent development of RDS.