Which neonatal respiratory problems are associated with gestational diabetes mellitus (GDM)?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

The nondiabetic fetus achieves pulmonary maturity at a mean gestational age of 34-35 weeks. By 37 weeks' gestation, more than 99% of healthy newborn infants have mature lung profiles as assessed by phospholipid assays. However, in a diabetic pregnancy, the risk of respiratory distress may not pass until after 38.5 gestational weeks.

Until recently, neonatal respiratory distress syndrome was the most common and serious morbidity in infants of diabetic mothers. In the 1970s, improved prenatal maternal management for diabetes and new techniques in obstetrics for timing and mode of delivery resulted in a dramatic decline in its incidence, from 31% to 3%. [50] Nevertheless, respiratory distress syndrome continues to be a relatively preventable complication.

The majority of the literature indicates a significant biochemical and physiologic delay in infants of diabetic mothers. Tyden et al [51] and Landon and colleagues [52] reported that fetal lung maturity occurred later in pregnancies with poor maternal glycemic control, regardless of class of diabetes.


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