High maternal levels of hemoglobin A1c associated with delayed fetal lung maturation in insulin-dependent diabetic pregnancies.
Phosphatidylglycerol (PG) in 227 amniotic fluid specimens obtained by amniocentesis during the third trimester and hemoglobin A1c (Hb A1c) in 889 maternal blood specimens obtained between 6 and 39 gestational weeks were measured for 115 singleton insulin-dependent diabetic pregnancies without major fetal malformations or stillbirths. The fetuses of diabetics whose mean Hb A1c during pregnancy was 8.5% or more remained PG-negative more often than those in the pregnancies with the mean Hb A1c below 8.5% at 37 (4/7 vs. 8/68, chi 2 = 10.2, p less than 0.01) and 38 (2/7 vs. 2/84, chi 2 = 5.2, p less than 0.05) completed weeks of gestation. The fetuses of the patients with a mean Hb A1c 8.0% or more were more often PG-negative at 37 gestational weeks (7/15) than those in the pregnancies with a mean Hb A1c below 8.0% (5/60, chi 2 = 10.4, p less than 0.005). Because Hb A1c reflects long-term blood glucose levels, the results suggest that maternal hyperglycemia, or other metabolic disturbances associated with hyperglycemia, is the cause of delayed fetal lung maturation among insulin-dependent diabetics.
Ylinen
K
K
Department I of Obstetrics and Gynecology, University Central Hospital, Helsinki, Finland.
D000293:Adolescent; D000328:Adult; D000649:Amniocentesis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D005260:Female; D005325:Fetal Organ Maturity; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000209:etiology; D012307:Risk Factors
D006442:Glycated Hemoglobin