IS LUNG MATURATION RELATED TO FETAL GROWTH IN DIABETIC OR HYPERTENSIVE PREGNANCIES

The purpose of this study was to determine whether infants sufficientl y affected by maternal diabetes or hypertension to exhibit abnormal gr owth (macrosomia, growth retardation) would also display significant a lteration in timing of pulmonary maturity (delay or acceleration, resp ectively). We studied 874 consecutive women with fetal pulmonary matur ity testing prior to delivery. Patients were stratified by birth weigh t into fetal size categories (small for gestational age [SGA], appropr iate for gestational age [AGA], large for gestational age [LGA]). Case s were compared based on maternal disease, fetal size categories and p ulmonary maturity testing results. Pulmonary maturity rates based on b oth phosphatidylglycerol (PG) and lecithin/sphingomyelin ratio (L/S) d id not differ between term LGA infants of diabetic mothers (97% and te rm LGA (80% or AGA (97% infants of non-diabetic, non-hypertensive moth ers. When compared based on PG alone, there was no difference between the rate of positive PG in term AGA infants of nonhypertensive, non-di abetic mothers (75%) and that seen in the other pregnancy groups (33-8 0%. Breakdown by gestational age revealed no significant differences i n maturity rates between the study groups. Macrosomic diabetic infants and growth-retarded hypertensive infants are no different from contro ls in their timing of fetal pulmonary maturation.