Delayed lung maturation in the macrosomic offspring of genetically determined diabetic (db/+) mice

We studied a genetically determined diabetes in pregnancy, the heterozygous diabetes (db/+) mouse. We found that fetal mice from these pregnancies are macrosomic with increased body, lung, and placenta wt, have altered organ protein, DNA and phospholipid content, and exhibit abnormal carbohydrate metabolism with increased liver and glycogen content. We further studied the effect of increased substrate availability and utilization on lung growth and maturation in (db/+) fetal mice, by measuring lung phospholipid synthesis as represented by the incorporation of the radiolabeled precursors, [3H]choline and [14C]glycerol, in fetal lung at 18 days' gestation (term = 19). Diabetic fetuses incorporated significantly more [3H]choline into disaturated phosphatidylcholine than controls (1.32 +/- 0.10 X 10(-2) versus 0.78 +/- 0.05 X 10(-2) nmol/g protein/min, mean +/- SE; p less than 0.001), but significantly less [14C]glycerol into phosphatidylglycerol than controls (3.18 +/- 0.38 versus 4.91 +/- 0.53 nmol/g protein/min, mean +/- SE; p less than 0.002), and their phosphatidylglycerol/phosphatidylinositol synthesis ratios were decreased (1.81 +/- 0.18 versus 3.17 +/- 0.14; mean +/- SE; p less than 0.001). Diabetic fetal lungs appeared morphologically less mature than controls at 18 days' gestation, as shown by a significantly decreased air space density (0.27 +/- 0.01 versus 0.43 +/- 0.02, mean +/- SE; p less than 0.001) and alveolar epithelial cell/total tissue ratio (0.54 +/- 0.02 versus 0.66 +/- 0.03, mean +/- SE; p less than 0.01). The increased synthesis of lung disaturated phosphatidylcholine in diabetic fetal mice may reflect the enhancement of body and lung growth in these macrosomic fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurological condition of large-for-gestational-age infants during the newborn period

Thirty-two large-for-gestational-age (LGA) infants and 46 appropriate-for-gestational-age (AGA) infants used as controls, were investigated. LGA and AGA infants did not differ regarding instrumental deliveries or asphyxia. The infants were examined on the 1st and 5th days after birth with a standardized neurological assessment. The LGA infants showed a significantly delayed neurological adaptation with fewer optimal responses on day one as compared to the AGA infants. These differences were not observed on day five. There were no neurological differences between prenatally and postnatally detected LGA infants. No significant differences were observed regarding parity on maternal complications, neonatal course, and neurological scores of the LGA infants.

Benign extra-axial collections of infancy

The clinical histories, physical examinations and results of head computed tomography and head ultrasound scans were reviewed in a group of 15 infants who had macrocrania, excessive extra-axial fluid and normal development. Diagnostic evaluations demonstrated mild ventriculomegaly and extra-axial fluid collections. No treatment was undertaken. All infants continued to exhibit normal development during a period of extended follow-up. In this select group of infants exhibiting these findings, treatment appears to be unnecessary and the prognosis for continued normal development is excellent.