Zapata A, Grande C, Hernández-García J M
Servicio de Bioquímica, Hospital La Paz, Universidad Autónoma, Madrid, Spain.
Scand J Clin Lab Invest. 1994 Oct;54(6):431-4. doi: 10.3109/00365519409085466.
We studied the relationship between the metabolic control of pregnant diabetics and fetal lung maturity. In 31 diabetic and 20 normal pregnancies we analysed phospholipids in amniotic fluid and glycaemic control parameters. There were no differences in amniotic fluid lecithin/sphingomyelin (L/S) and phosphatidylinositol/sphingomyelin (PI/S) ratios between pregnant diabetics with strict metabolic control and the control group. Pregnant diabetics with poor metabolic control had significantly different L/S and PI/S ratios than the normal pregnant women. Six women in this group of poorly controlled diabetics had mature surfactant in amniotic fluid (L/S > or = 2.7 and presence of phosphatidylglycerol) at 32-34 weeks of amenorrhea; the difference was significant (p < 0.05) with respect to the control group. These six women had recurrent hypoglycaemic episodes (6.4 +/- 1.3 episodes/week) at 14-27 weeks of amenorrhea. Our findings suggest that hypoglycaemic stress on the fetus could disturb fetal synthesis of pulmonary phospholipids.
我们研究了妊娠糖尿病患者的代谢控制与胎儿肺成熟度之间的关系。在31例糖尿病妊娠和20例正常妊娠中，我们分析了羊水磷脂和血糖控制参数。严格代谢控制的妊娠糖尿病患者与对照组的羊水卵磷脂/鞘磷脂（L/S）和磷脂酰肌醇/鞘磷脂（PI/S）比值无差异。代谢控制不佳的妊娠糖尿病患者的L/S和PI/S比值与正常孕妇有显著差异。在这组代谢控制不佳的糖尿病患者中，有6名女性在闭经32 - 34周时羊水有成熟的表面活性物质（L/S≥2.7且存在磷脂酰甘油）；与对照组相比差异显著（p<0.05）。这6名女性在闭经14 - 27周时有反复低血糖发作（6.4±1.3次/周）。我们的研究结果表明，胎儿的低血糖应激可能会干扰胎儿肺磷脂的合成。
