Question on fetal lung maturity in diabetic patient

ham22 · Apr 15, 2005

Hi! I was wondering if anyone can answer a couple of question for me - I was told today that women who are diabetic have a much higher risk of having babies with problems due to fetal lung maturity. Basically I was taking care of a diabetic patient today who was 35 weeks gestation and was told by another nurse that this patient's baby had a higher risk of problems due to fetal lung immaturity..can anyone tell me the rationale behind this?

I don't have any experience with OB nursing but I can tell you from personal experience. I had Gestational Diabetes with my first baby and was never told anything about that. Their main concern was that I follow my diet and keep my sugars regulated so the baby was not too big and so that his sugars would be ok when he was born. Other than that I don't know. :twocents: Maybe do an internet search? That always seems to help me. :clown:

Jolie, BSN · Apr 16, 2005

Your nurse friend is correct. Infants born to diabetic mothers do have a higher incidence of respiratory distress than other newborns. There are a few reasons for this:

1. The lungs of infants of diabetic mothers (IDMs) mature more slowly in utero than those of other babies. I'm not sure why that is, but if you compare a group of 35 week IDMs to a group of 35 week non-IDMs, the IDMs will have a greater incidence of lung immaturity and respiratory distress syndrome (RDS). I use 35 weeks as an example; this holds true at all gestational ages.

2. IDMs are more likely to be delivered early due to medical complications than non-IDMs, thus putting them at risk for the lung problems associated with prematurity, most notably RDS.

3. IDMs are more likely to be delivered by C-section than non-IDMs, thus putting them at risk for lung problems potentially associated with C-sections, such as transcient tachypnea of the newborn (TTN), a relatively short-lived disorder characterized by tachypnea, grunting, nasal flaring, retractions, and decreased oxygen saturation. This is more mild than RDS, but is treated in a similar manner with IV hydration, supplemental oxygen, and possibly IV antibiotics until sepsis is ruled out.

4. IDMs have a greater incidence of cardiac anomolies, which may present with respiratory symptoms.

Finally, remember that IDMs are often large for gestational age (LGA) and may appear "older" than they really are. For example, an 8lb. 36 week infant is still a preemie, and at risk for all the problems of prematurity, even though he is bigger than some of the term babies in the nursery.

ham22 · Apr 16, 2005

Your nurse friend is correct. Infants born to diabetic mothers do have a higher incidence of respiratory distress than other newborns. There are a few reasons for this:
1. The lungs of infants of diabetic mothers (IDMs) mature more slowly in utero than those of other babies. I'm not sure why that is, but if you compare a group of 35 week IDMs to a group of 35 week non-IDMs, the IDMs will have a greater incidence of lung immaturity and respiratory distress syndrome (RDS). I use 35 weeks as an example; this holds true at all gestational ages.
2. IDMs are more likely to be delivered early due to medical complications than non-IDMs, thus putting them at risk for the lung problems associated with prematurity, most notably RDS.
3. IDMs are more likely to be delivered by C-section than non-IDMs, thus putting them at risk for lung problems potentially associated with C-sections, such as transcient tachypnea of the newborn (TTN), a relatively short-lived disorder characterized by tachypnea, grunting, nasal flaring, retractions, and decreased oxygen saturation. This is more mild than RDS, but is treated in a similar manner with IV hydration, supplemental oxygen, and possibly IV antibiotics until sepsis is ruled out.
4. IDMs have a greater incidence of cardiac anomolies, which may present with respiratory symptoms.
Finally, remember that IDMs are often large for gestational age (LGA) and may appear "older" than they really are. For example, an 8lb. 36 week infant is still a preemie, and at risk for all the problems of prematurity, even though he is bigger than some of the term babies in the nursery.

Wow! I can't believe my Doc never told me any of this. Scary stuff! At least I will know about it this time and I will be sure to ask lots of questions.

nursemommie · Aug 19, 2011

Thank you so much! I'm studying for a test and this just answered sooo much!!