الفهرس 
Subject and methodsOnly 14 pages are availabe for public view
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Abstract
Respiratory distress syndrome is one of the most important causes of perinatal morbidity and mortality. The etiopathogenesis of this syndrome is complicated and multifactorial, so the objective of the present study was to evaluate cord blood prolactin level in full term diabetic deliveries and premature deliveries in comparison with full term deliveries as a trial to study its relation to neonatal lung
function.
The study comprised 30 women with uncomplicated pregnancy ending by normal full term vaginal delivery as control group, 20 full term (37-38.5) weeks pregnant women with controlled type I (insulin-dependent) diabetes mellitus ending by normal full term delivery and 20 pregnant women who had premature delivery (32-36) weeks with no complication other than prematurity.
For all neonates gestational age was determined using Dubowitz score (physical and neurological), according to last menstrual period data and using ultrasound examination. Also, cord blood samples were examined for
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estimation of prolactin level. All neonates were evaluated and followed up for the occurrence of respiratory distress
syndrome.
There was a non-significant (P>0.05) difference between the three groups as regards the maternal age, despite a significantly (P<0.05) decreased gravidity and parity of diabetic women, compared to control group.
Gestational age determined depending on the date of last menstrual period, prenatal ultrasound examination, and postnatal Dubowitz score, showed a significant (P<0.05) increase of age determined by both US and DW score for diabetic women, compared to that determined by LMP, with a non-significant difference between age determined by US and DW score for diabetic women. However, for women included in control and prematurity groups, there was a non-significant difference between the determined ages within each group, by any of the used modalities.
Fasting blood sugar was significantly increased in diabetic women compared both to the control and preterm groups, with a non-significant difference in between.
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The frequency of CS was significantly decreased in preterm group compared both to the control group (X2=4.65, P<0.05) and to the diabetic group, (X2=6.81, P<0.05). Also, the rate of vacuum-aided vaginal delivery was significantly increased in control group compared both to diabetic, (X2=5.12, P<0.05) and preterm groups, (X2=5.69, P<0.05). On the other hand, the frequency of the need for CS was significantly higher in diabetic group compared to the control group, (X2=7.46, P<0.05).
Apgar score, 1-min postnatal, showed a significant decrease in both diabetic (P=0.005) and preterm (P<0.001) newborns compared to the control group. Moreover, at 5-min postnatal, Apgar score showed a significant decrease in diabetic (P=0.036) and preterm (P=0.009) newborns compared to the control newborns.
There was a significant difference between the three groups as regards the frequency of RDS in favor of preterm group, (X2= 8.9, P<0.05).
There was a non-significant (P>0.05) decrease of cord serum prolactin levels in newborns to diabetic mothers
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compared to the control levels. Neonates born for diabetic mothers and had RDS had mean cord prolactin of 251.5 ±14.8 ng/dl; while those who did not develop RDS had mean cord prolactin level of 257.7 ±34.3 ng/dl, with a non-significant decrease of cord prolactin levels in neonates developed RDS. Moreover, there was a positive significant correlation between cord serum prolactin level in neonates born for diabetic mothers and the frequency of occurrence of RDS, (r = 0.559, P = 0.030).
There was a significant (P<0.05) increase of cord serum prolactin level in preterm neonates having RDS compared to those have not, moreover, there was a positive highly significant correlation between cord serum prolactin level and the frequency of RDS in preterm neonates, (r = 0.812, P = 0.0001).