John P. Hubbell

Association between maternal diabetes and the respiratory-distress syndrome in the newborn.

Abstract Perinatal data on 805 infants of diabetic mothers and 10,152 infants of nondiabetic mothers were examined for a relation between maternal diabetes and respiratory-distress syndrome of the newborn. The syndrome occurred in 23.4 per cent of the diabetic vs. 1.3 per cent of the nondiabetic group. The risk of the syndrome in an infant of a diabetic mother was 23.7 times greater than that for an infant of a non diabetic mother (P < 0.00001). Further analysis to control for features associated with diabetes but also in themselves risk factors, such as gestational age and route of delivery, showed that respiratory-distress syndrome in infants of diabetic mothers was 5.6 times as likely to develop as in infants of nondiabetic mothers (P < 0.00001). Thus, maternal diabetes mellitus per se predisposes to newborn respiratory-distress syndrome. (N Engl J Med 294:357–360, 1976)

Congenital heart disease in infants of diabetic mothers

A review of 470 infants of diabetic mothers followed at the Joslin Clinic, Boston, revealed a 4 per cent incidence of proved congenital heart disease, five times the number expected to appear in the general population. Transposition of the great arteries, ventricular septal defect, and coarctation of the aorta together composed over one half of the 19 cases reported. No relationship between gestational factors and incidence of heart defects was observed. Although no single specific clue exists to identify congenital heart disease in infants of diabetic mothers, the abnormal electrocardiogram, presence of cyanosis without radiographic evidence of pulmonary disease, or significant murmur should bring attention to the likelihood of heart disease.

Evolution of postural reflexes in normal infants and in the presence of chronic brain syndromes

IN CONNECTION WITH a study of the evolution of postural rdexes in neurologically abnormal infants, it became apparent that existing information about the ages at which various changes take place in these reflexes in normal children needed to be amplified. Particularly, the range of variation of normal was not clear from reports in the literature, and it is clearly essential to know the outer limits of normal in order to interpret apparent abnormalities.

Infants of Diabetic Mothers: Neonatal Problems and Their Management

A study of neonatal problems of 329 liveborn infants of diabetic mothers indicates that prematurity is the single most significant factor influencing outcome. The direct relationship of prematurity to increased incidence of respiratory distress syndrome, hyperbilirubinemia, and neonatal mortality is demonstrated. Severity of maternal diabetes, while extremely important in relation to stillbirth, does not seem to be as significant a factor in liveborn infants. The present plan of care designed to deal with these problems in liveborn infants at the Boston Lying-in Hospital has been presented.

A rapid aseptic scrub technique for nurseries of the newborn

Abstract 1. 1. The results are presented of a study based on bacteriological data to determine the effect of a new soap substitute. 2. 2. This material, hexachlorophene and pHisoderm, is a safe agent for hand scrubbing. It appears to have a remarkable bacteriostatic action when used regularly. 3. 3. A rapid aseptic scrub technique employing this material for cleansing the hands is outlined for the use of personnel working in nurseries of the newborn.

ASSOCIATION BETWEEN MATERNAL DIABETES AND THE RESPIRATORY DISTRESS SYNDROME IN THE NEWBORN

Perinatal data on 805 infants of diabetic mothers and 10,152 infants of nondiabetic mothers were examined for a relation between maternal diabetes and respiratory-distress syndrome of the newborn. The syndrome occurred in 23.4 per cent of the diabetic vs. 1.3 per cent of the nondiabetic group. The risk of the syndrome in an infant of a diabetic mother was 23.7 times greater than that for an infant of a nondiabetic mother (P less than 0.00001). Further analysis to control for features associated with diabetes but also in themselves risk factors, such as gestational age and route of delivery, showed that respiratory-distress syndrome in infants of diabetic mothers was 5.6 times as likely to develop as in infants of nondiabetic mothers (P less than 0.00001). Thus, maternal diabetes mellitus per se predisposes to newborn respiratory-distress syndrome.