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Molecular Mechanisms of Maternal Diabetes Effects on Fetal and Neonatal Surfactant

1
Departments of Pediatrics (Neonatology), UH Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH 44106, USA
2
Departments of Pediatrics (Neonatology), Medical University of South Carolina, Charleston, SC 29425, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Roberto W. Dal Negro
Received: 15 February 2021 / Revised: 25 March 2021 / Accepted: 2 April 2021 / Published: 6 April 2021
(This article belongs to the Special Issue Neonatal Respiratory Distress)
Respiratory distress is a significant contributor to newborn morbidity and mortality. An association between infants of diabetic mothers (IDMs) and respiratory distress syndrome (RDS) has been well recognized for decades. As obesity and diabetes prevalence have increased over the past several decades, more women are overweight and diabetic in the first trimester, and many more pregnant women are diagnosed with gestational diabetes. Glycemic control during pregnancy can be challenging due to the maternal need for higher caloric intake and higher insulin resistance. Surfactant is a complex molecule at the alveolar air–liquid interface that reduces surface tension. Impaired surfactant synthesis is the primary etiology of RDS. In vitro cell line studies, in vivo animal studies with diabetic rat offspring, and clinical studies suggest hyperglycemia and hyperinsulinemia can disrupt surfactant lipid and protein synthesis, causing delayed maturation in surfactant in IDMs. A better understanding of the molecular mechanisms responsible for surfactant dysfunction in IDMs may improve clinical strategies to prevent diabetes-related complications and improve neonatal outcomes. View Full-Text
Keywords: surfactant protein; surfactant lipids; infants of a diabetic mother; respiratory distress syndrome; lung development; hyperglycemia surfactant protein; surfactant lipids; infants of a diabetic mother; respiratory distress syndrome; lung development; hyperglycemia
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MDPI and ACS Style

Yildiz Atar, H.; Baatz, J.E.; Ryan, R.M. Molecular Mechanisms of Maternal Diabetes Effects on Fetal and Neonatal Surfactant. Children 2021, 8, 281. https://0-doi-org.brum.beds.ac.uk/10.3390/children8040281

AMA Style

Yildiz Atar H, Baatz JE, Ryan RM. Molecular Mechanisms of Maternal Diabetes Effects on Fetal and Neonatal Surfactant. Children. 2021; 8(4):281. https://0-doi-org.brum.beds.ac.uk/10.3390/children8040281

Chicago/Turabian Style

Yildiz Atar, Hilal, John E. Baatz, and Rita M. Ryan 2021. "Molecular Mechanisms of Maternal Diabetes Effects on Fetal and Neonatal Surfactant" Children 8, no. 4: 281. https://0-doi-org.brum.beds.ac.uk/10.3390/children8040281

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