Influence of glycemic control on fetal lung maturity in gestations affected by diabetes or mild hyperglycemia
MetadataShow full item record
Objective. To evaluate the influence of glycemic control on fetal lung maturity in pregnancies affected by diabetes or mild hyperglycemia. Design. Cross-sectional study. Setting. Level III maternity center. Population. A total of 187 pregnant women were submitted to routine amniocentesis for the assessment of fetal lung maturity up to 72 hours before delivery. Methods. Fetal lung maturity thresholds were: Clements-positive at a dilution of 0.5; OD(650) nm >= 0.15; and lamellar body count (LBC) >= 32,000/mu l. The relation of test results with adequate (<= 6.7 mmol/l) or poor (> 6.7 mmol/l) glycemic mean (GM) at term and at preterm was evaluated. Main outcome measure. Delay in fetal lung maturity when glycemic control was poor. Results. Glycemic control was adequate in 146 (78.1%) women. Clements maturity rates were higher at term (91.9%) than at preterm (64.7%) when GM <= 6.7 mmol/l (p < 0.001), but not when control was inadequate. LBC median was higher at term (99.0; 62.0-154.0) than at preterm (66.5; 40.5-108.25) (p = 0.009) when GM <= 6.7 mmol/l, while GM > 6.7 mmol/l did not lead to any difference between these rates at term or preterm. When glycemic control was adequate, OD(650) nm medians at term and at preterm were similar. However, when GM > 6.7 mmol/l, OD(650) nm median at term (0.29; 0.22-0.40) was higher than that observed at preterm (0.15; 0.12-0.18) (p < 0.001). Conclusions. Our results suggest that in term pregnancies routine amniocentesis for the assessment of fetal lung maturity should be abandoned. In preterm pregnancies, or when glycemic control is inadequate it is recommended.
How to cite this document
Showing items related by title, author, creator and subject.
Pinho, Sheila Zambello de ; Oliveira, José Brás Barreto de ; Gazola, Rodrigo José Cristiano ; Mazotti, Adriano César ; Molero, Camila Schimite ; Mendes, Carolina Borghi ; Mello, Denise Fernandes de ; Marques, Emilia de Mendonça Rosa ; Talamoni, Jandira Liria Biscalquini ; Silva, José Humberto Dias da et al. (Coleção PROGRAD (UNESP), 2011) [Livro]
Pinho, Sheila Zambello de ; Oliveira, José Brás Barreto de ; Pontes, Sueli Rodrigues ; Almeida, Djanira Soares de Oliveira e ; Godoy, Kathya Maria Ayres de ; Rosa, Claudia de Souza ; Nunes, Julianus Araújo ; Salvador, Sérgio Azevedo ; David, Célia Maria ; Vilche Peña, Angel Fidel et al. (Coleção PROGRAD (UNESP), 2011) [Livro]
Pinho, Sheila Zambello de ; Spazziani, Maria de Lourdes ; Mendonça, Sueli Guadelupe de Lima ; Rubo, Elisabete Aparecida Andrello ; Villarreal, Dalva Maria de Oliveira ; Duarte, Camila ; Okamoto, Mary Yoko ; Souza, Thais R. ; Garms, Gilza Maria Zauhy ; Marin, Fátima Aparecida Dias Gomes et al. (Coleção PROGRAD (UNESP), 2012) [Livro]