Surfactant associated protein (SAP-35) in amniotic fluid from diabetic and nondiabetic pregnancies.
We have recently shown that, with the current management of insulin-dependent diabetes during pregnancy, infants of diabetic mothers are at no greater risk of respiratory distress syndrome (RDS) than an appropriately matched control population. A previous study suggested a selective inhibition of surfactant associated protein of 35,000 daltons (SAP-35) in the amniotic fluid of diabetic pregnancies. In order to determine whether a selective inhibition of SAP-35 occurs in well controlled, insulin-dependent diabetic pregnancies, we compared SAP-35 concentration and lecithin/sphingomyelin (L/S) ratios in amniotic fluid from 30 well controlled, insulin-dependent women with 30 nondiabetic pregnant women pair-matched for gestational age, race, and indication for amniocentesis. Gestational ages ranged from 30-43 weeks, with a mean of 36.5 +/- 2.5 weeks, in both groups. Surfactant associated protein-35 was measured by an enzyme-linked capture immunoassay specific for SAP-35 and its oligomers. Mean +/- SEM SAP-35 was 3.7 +/- 0.4 micrograms/mL (N = 30) in the diabetic group, not significantly different from 5.0 +/- 1.1 micrograms/mL (N = 30) in the control group (P greater than .05). Mean L/S ratios were also not different: 2.4 +/- 0.1 (diabetic) compared with 2.3 +/- 0.1 (control); P greater than .05. The rate of RDS was similar in both groups. We conclude that in well controlled diabetic pregnancies, fetal lung maturation, as assessed by the L/S ratio, SAP-35 concentration, and outcome, is not adversely affected.
D000653:Amniotic Fluid / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005325:Fetal Organ Maturity; D006023:Glycoproteins / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism*; D011510:Proteolipids / Q000032:analysis*; D037662:Pulmonary Surfactant-Associated Protein A / Q000031:analogs & derivatives*; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000032:analysis*; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology; D012306:Risk
D006023:Glycoproteins; D011510:Proteolipids; D037662:Pulmonary Surfactant-Associated Protein A; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants; C445842:SFTPA1 protein, human