Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to evaluate the surfactant maturation of the neonate, tracheal aspirates were analyzed in 84 newborn infants with 12h of birth. Using 2-dimensional thin-layer chromatography, 9 different phospholipids were identified. Dynamic surface tension measurements were performed with a modified Wilhelmy balance. Five different groups of infants with typical phospholipid patterns were characterized: i.e., 1. Normal term newborn. 2. RDS in the preterm infant. 3. Acceleration of lung maturity in preterm infants without RDS. 4. Retardation in term infants with RDS. 5. Therapeutic induction of pulmonary maturity in preterm infants following maternal glucocorticoid administration. Mature lung effluent contains high concentrations of phosphatidylcholine (PC) and phsophatidylglycerol (PG). In infants with RDS, PC is low and PG absent. Accelerated lung maturity was observed after chronic prenatal stress, such as prolonged rupture of the membranes, chronic vaginal bleeding, and maternal hepatitis or drug addiction. Retardation of pulmonary maturity was seen in infants with alpha-1-AT-deficiency, maternal diabetes and maternal hypothyroidism. Administration of methylprednisolone to the mother 24 h to 72h before birth induced both the synthesis of PC and PG in the preterm infants, resulting in an almost full-term phospholipid pattern as early as 31 weeks of gestation. The significance of these factors on the pathogenesis of RDS is discussed.
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PMID:Factors influencing surfactant composition in the newborn infant. 30 91

The phospholipids in amniotic fluid from diabetic pregnancies were compared with those in normal pregnancies. There was little difference in the lecithin/sphingomyelin (L/S) ratios on the basis of the gestational ages. However, in diabetic pregnancies, phosphatidylglycerol (PG) was absent or low, and phosphatidylinositol (PI) remained high even if the L/S ratio was greater than 2. The phosphatidylglycerol/phosphatidylinositol (PG/PI) ratio was expressed as a function of the L/S ratio. The PG/PI ratio was significantly lower in maternal diabetes. Respiratory distress syndrome (RDS) coincided with an L/S ratio of between 2.0 and 3.0 only when PG was absent. Infants of insulin-dependent diabetic mothers with a particularly low PG/PI ratio (less than 50% of the median) had higher relative birth weights and more often had hypoglycemia than those infants born to mothers with a high PG/PI ratio (greater than 200% of the median). The phospholipids of amniotic fluid correlate with fetal functional maturity and may reflect deviations of hormonal balance required for normal perinatal development.
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PMID:Amniotic fluid phospholipid profile as a predictor of fetal maturity in diabetic pregnancies. 51 55

Cord blood thyroxine (T4) concentrations were measured in 4,068 infants from 28 wk gestation to term. Each chart was reviewed for the following factors: delivery by cesarean section, prolonged rupture of membranes, neonatal asphyxia, meconium-stained amniotic fluid, maternal diabetes mellitus and twinning. Each neonate was evaluated for the Idiopathic Respiratory Distress Syndrome, and low (SGA) or high (LGA) birthweight for gestational age. Within each gestational age group, the mean cord T4 value was similar except for a significantly lower mean cord T4 concentration for the term SGA subgroup. Thus, inclusion of the infant with a complicated neonatal course or the infant born to a high-risk mother in mass screening programs for congenital hypothyroidism using cord serum will not increase the number of false-positive T4 values.
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PMID:The effect of perinatal factors on cord thyroxine concentration. 55 30

The efficacy of correlating the L/S ratio in the amniotic fluid with fetal lung maturity has been substantiated in normal pregnancies. In gestations complicated by fetomaternal diseases, however, the assay is less reliable. This study involves 555 pregnancies in which there was a significant maternal, fetal, or placental disorder. The L/S ratio was related to fetal respiratory maturity as measured by Dubowitz criteria and the occurrence of RDS. The results show that pre-eclampsia, chronic hypertension, diabetes (Class D, E, F), significant cardiovascular disease, severe hemoglobinopathies, various congenital anomalies, chronic placental insufficiency, and prolonged ruptured membranes accelerated the L/S ration. Conversely, mild diabetes (Class B, C), intrinsic renal disease, hepatitis, collagen disease, hydrops fetalis, syphilis, and toxoplasmosis were associated with a delay in the L/S ratio. A significant increase in erroneous responses was noted in these patients when the L/S ratio was correlated to infant maturity and to the incidence of RDS. Possible mechanisms for these findings are discussed.
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PMID:The lecithin/sphingomyelin ratio in cases associated with fetomaternal disease. 57 73

In the period between 1973 and 1976, in order to prevent neonatal RDS, 24 insulin-dependent diabetic mothers were given Dexamethason before delivery. The treated group was compared with a control group comprising 26 women of the same gesational age, severity of diabetes and mode of delivery. Neonatal care was similar in both groups. In the group where steroid prophylaxis was applied, decrease of RDS morbidity and mortality was observed. The authors accentuate that Dexamethason given to the mother may have an unfavourable effect on carbohydrate metabolism. Therefore, it is recommended to perform 4-hour determinations of blood sugar, urinary sugar and acetone and accordingly, modification of therapy.
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PMID:[Prevention of respiratory distress syndrome in pregnant diabetic women during labor]. 61 Feb 35

The authors used Dexamethasone before delivery in 577 cases of pregnancy. There were 460 prematurities. Occurrence of RDS was significantly lower in cases, where delivery took place more than 48 hours after the steroid treatment. Where the steroid effect was not optimum (48 hours), the RDS was similar to that of the control group, although mild in form. In their studies they found no connection between the tocolysis (Partusisten) and the occurence of RDS. They emphasize that in the cases where respiratory insufficiencies are predisponated (elective caesarean section, diabetes mellitus etc.) the steroids significantly reduce the frequency of the disease. Neither the number of apoplexy nor that of death due to infections increase in dexamethasone treatment.
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PMID:[Relationship of time interval between steroid therapy and labor to the incidence of respiratory distress syndrome]. 68 65

Recent advances in antepartum fetal evaluation have contributed to a marked reduction in fetal deaths in pregnancies complicated by overt diabetes mellitus. To determine the effect of these changes on neonatal morbidity and mortality, a retrospective analysis of complications in 322 infants of diabetic mothers (IDM) in White classes B--R was undertaken. The majority (89 per cent) of the IDM were delivered at term with a mean gestational age of 38 weeks. Neonatal morbidity correlated significantly with gestational age, occurring in 80 per cent of the preterm and 40 per cent of the term infants. The overall incidence of complications was: hyperbilirubinemia 37 per cent, hypoglycemia 31 per cent, hypocalcemia 13 per cent, polycythemia 8 per cent, and necrotizing enterocolitis 2 per cent. Respiratory distress syndrome (RDS) occurred in 9 per cent and congenital malformations in 6 per cent of the infants. Nine infants died, and four of these deaths were due to anomalies. These data indicate that (1) a reduction in fetal mortality has been accompanied by a reduction in neonatal mortality; (2) neonatal morbidity has been decreased but remains significant in the IDM; and (3) congenital anomalies have replaced RDS as a major cause of neonatal death for the IDM.
Diabetes Care
PMID:Current patterns of neonatal morbidity and mortality in infants of diabetic mothers. 72 46

An experience with the lecithin/sphingomyelin (L/S) ratio in a population of high-risk obstetric patients is presented. A wide range of values in ralation to gestational age was found. A delayed rise in L/S ratio was found in Class A diabetes and Rh sensitization but was most striking in Class B through F diabetes. Chronic hypertension alone or in combination with diabetes is associated with an earlier rise in L/S ratio. A poor correlation of L/S ratio and neonatal pulmonary outcome with birthweight and gestational age was found. However, a good correlation between L/S ratio and neonatal pulmonary outcome was apparent. An L/S ratio of over 2 was universally associated with absence of serious RDS, but a low L/S ratio was less precisely predictive.
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PMID:The lecithin/sphingomyelin ratio in a high-risk obstetric population. 81 62

Dexamethason in a total dose of 15 mg was given in 125 cases of premature labour 48 hours before delivery to prevent the development of respiration distress syndrome. Clinically, the incidence of RDS was 14,5% (18 cases) in the treated group, while in the control group it was 27,7% (32 cases out of 119). Owing to RDS two prematures died in the treated group, and 14 in the control one. Steroid prophylaxis was applied prenatally with 69 pregnant women at term who were predisposed to give birth to infants developing RDS (retardation, diabetes mellitus, elective section caesareas, etc.). Five neonates developed RDS and one died of hyaline membrane disease. The authors studied the effect of steroids on carbohydrate metabolism and total oestrogen excretion in the urine. From profile examinations of blood sugar it was concluded that no pathological alterations take place in maternal carbohydrate metabolism due to intravenous or intermittent prolonged administration of Dexamethason. After one single large dose (15 mg) of Dexamethason a reduction of 30-40% was noted in total oestrogen excretion. Return to the initial value was noted on the 11th-12th day. No appreciable changes were observed with prolonged intermittently given Dexamethason. On the basis of their observations the authors consider that steroid therapy applied during labour is efficient in preventing neonatal RDS.
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PMID:[Prevention of respiratory distress syndrome prior to delivery using steroids]. 89 45

The average estradiol concentrations in umbilical cord plasma from newborns which developed respiratory distress with or without hyaline membrane disease (RDS) were lower by 25% than in controls. Complication of pregnancy by maternal diabetes or pruritus has been associated with abnormalities in estrogen concentrations in the mother, but cord plasma estradiol levels in these cases were essentially normal. Because of reports that treatment of the mother before delivery with estrogens or glucocorticoids results in a decreased incidence of RDS in newborns the relationship between endogenous estradiol and cortisol levels in cord plasm was investigated. There was no significant correlation between the concentrations of these steroids in 65 specimens; the cortisol levels associated with two cases of severe RDS were low.
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PMID:Umbilical cord plasma estradiol levels in relation to complications of pregnancy and newborn and to cortisol levels. 117 1


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