FINANCIAL DISCLOSURE: The authors h

FINANCIAL DISCLOSURE: The authors have indicated they have
no financial relationships relevant to this article to disclose.Since the early 1970s, it has been recognized
that diabetes mellitus (DM) is
a risk factor for respiratory distress
syndrome (RDS).1,2 The relationship between
maternal DM and RDS has also
been studied at the basic science level.
Early reports revealed lower lecithin/
sphyngomyelin ratios in the amniotic
fluid of pregnancies complicated by
DM.3,4 Infants of diabetic mothers
(IDM) are frequently hyperinsulinemic
or have insulin resistance.5 It has been
shown that insulin inhibits the accumulation
of surfactant protein A (SP-A)
and SP-B messenger RNA (mRNA)6,7
whereas it has no effect on SP-C mRNA
levels in human fetal lung tissue maintained
in vitro.8 Most studies of RDS
and diabetes have not addressed the
issue of gestational diabetes.1,2,9 We
and others have demonstrated that
with modern management and adequate
glycemic control in pregnancy,
the concentrations of SP-B in amniotic
fluids of pregnancies complicated by
DM are not different from those of gestational
age (GA)-matched controls,
and that the risk of RDS may not be
increased beyond that of a nondiabetic
control population.9,10 However, in both
previous studies, the number of small
preterm infants at significant risk for
RDS was very limited, and the risk for
type II error significant.
A Cochrane database review concluded
that early prophylactic surfactant therapy
in infants at high risk for RDS reduces
mortality, as well as significant
complications of RDS.11 In contrast, a
randomized clinical trial has challenged
that opinion, as it seems that early nasal
continuous positive airway pressure
may be at least as effective as early prophylactic
surfactant therapy on major
short-term outcomes.12 Thus, within the
context of this controversy, it might be
important to determine whether preterm
IDM are at increased risk for RDS.
Since 1995, the Israel national very low
birth weight (VLBW [
1500 g]) infant
database has prospectively collected a
large number of selected variables on
all VLBW infants and is a powerful tool
for epidemiologic research in clinical
neonatology. We therefore used this
database to test the hypothesis that
the presence of maternal DM (pregestational
or gestational DM [GDM]) increases
the risk for mortality, RDS, and
major complications of prematurity
among preterm VLBW infants.

ผลลัพธ์ (แอฟริกา) 1:

Finansiële openbaarmaking. Die skrywers het, het hulle aangedui
. geen Finansiële Verhoudings met betrekking tot hierdie artikel te Disclose.Since die vroeë 1970's, het dit erken
. dat Diabetes mellitus (DM) is
'n risikofaktor vir nood Respiratoriese
Sindroom (RDS) .1,2 Die verhouding tussen
Moeder DM en RDS het ook
reeds by die basiese wetenskap vlak bestudeer.
Vroeë verslae Revealed Laer lesitien /
Sphyngomyelin Die verhoudings in amniotiese
vloeistof swangerskappe bemoeilik deur
DM.3,4 Babas van diabetiese moeders
(IDM) word dikwels Hyperinsulinemic
insulien of Het Resistance.5 Dit is
getoon dat insulien inhibeer die opeenhoping
van surfactant proteïen A (SP-A).
en SP-B boodskapper RNA (mRNA) 6,7.
terwyl dit het geen effek op SP-C mRNA.
vlakke in Menslike longweefsel fetale gehandhaaf.
Studies in Vitro.8 meeste van RDS
en Diabetes het nie aangespreek Die
Uitgawe van swangerskap Diabetes.1,2,9 Ons
Het en ander het getoon dat
met moderne bestuur en voldoende
glukemiese beheer in swangerskap,
die konsentrasies van SP-B in amniotiese.
Fluids van swangerskappe bemoeilik deur
DM verskil van dié van swangerskap nie.
Ouderdom (GA) -matched Beheer ,.
en dat kan nie die risiko van RDS.
toegeneem dat 'n nondiabetic Beyond
beheer Population.9,10 Maar in beide
Vorige studies, is die aantal klein
premature babas by beduidende risiko vir
RDS was baie beperk, en die risiko vir.
tipe II Fout betekenisvol.
A Cochrane Databasis hersiening gesluit
dat profilaktiese benatter Vroeë terapie
in babas by High verminder die risiko vir RDS.
sterftesyfer, sowel as belangrike
komplikasies van RDS.11 In teenstelling, 'n
het ewekansige kliniese proef uitgedaag
dat advies As dit blyk dat die vroeë nasale.
Deurlopende positiewe lugwegdruk
Mag minstens so effektief soos Vroeë profilaktiese.
benatter terapie op die groot
kort termyn Outcomes.12 Dus, binne die.
konteks van hierdie omstredenheid Dit kan wees
belangrik om te bepaal Of premature
IDM is 'n verhoogde risiko vir RDS.
Sedert 1995, Die Israel Nasionale baie laag.
geboortegewig (VLBW [? ​​1500 G]) baba.
databasis vooruitwerkend Collected n
Groot aantal geselekteerde veranderlikes op
al VLBW Babas en is 'n kragtige instrument
vir epidemiologic Kliniese Navorsing in
Neonatologie. Daarom is hierdie wat ons gebruik
databasis te toets Die hipotese dat
die teenwoordigheid van Moeder DM (Pregestational.
of swangerskap DM [GDM]) toeneem.
Die risiko vir sterfte, RDS, en.
groot komplikasies van prematuriteit
Onder premature VLBW babas.