Good glycemic control does not alter lamellar body count in pregnancies complicated with diabetes mellitus

Amaç

To evaluate the influence of diabetes with strict glycemic control on fetal lung maturity by using lamellar body counts (LBC) during pregnancy

Yöntem

Twenty-two diabetic and 53 non-diabetic pregnant women were conducted to the study. The glucose levels were strictly controlled and kept within normal ranges in all the diabetic women. The mean LBC, the rate of low LBC, the rate of neonatal intensive care unit stay (ICU), the rate of respiratory need and the pregnancy outcome were compared between the groups. Recent studies suggested a LBC ≥50.000µ/L to document fetal lung maturity; hence, this cut off was used for analyzing low and high LBC groups. The statistical analyses were conducted with Mann Whitney-U and Pearson chi-square tests. Binomial regression analysis was conducted to reveal the relation of low lamellar body count (LBC<50.000 µ/L) with gestational age, presence of diabetes, administration of antenatal steroids, cord blood pH, base deficit, neonatal intensive care unit stay and need for respiratory support. The related factors were reanalyzed in multinomial regression analyses to find out the independently related factor.

Bulgular

The mean age of women, characteristics of pregnancy and pregnancy outcome, antenatal corticosteroid administration rate, rate of neonatal intensive care unit stay and respiratory need were similar in the groups. The mean LBC and the rate of low LBC were also similar in the groups. We did not find a significant relation between the risk of low LBC and the presence of diabetes, antenatal corticosteroid administration, cord blood PH, base deficit and need of respiratory support. The risk of low LBC decreased with increasing gestational week (OR=0.597; 95% CI: 0.443-0.806, p=0.001). The low LBC was also related with the increased stay in neonatal intensive care unit (OR=30.2; 95% CI: 3.7-246.8, p=0.001). However, the relation of the latter became borderline significant, when its effect was analyzed together with gestational age in the multinomial regression analysis (OR=9.2; 95% CI: 0.947-88.95, p=0.056). The independent predictor of low LBC was the low gestational age (OR=0.693, 95% CI: 0.49-0.98, p=0.038).

Sonuç

Lamellar body count, thus fetal lung maturity and the neonatal outcome were not altered in diabetic pregnancies with good glycemic control. The only independent predictor of low LBC was low gestational age.

Anahtar Kelimeler

Lamellar body count, diabetic pregnancies

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