Respiratory distress and neonatal mortality in infants of diabetic and prediabetic mothers.

The 149 live births of 19 insulin-dependent diabetic mothers and 62 prediabetic mothers between 1940 and 1970 were reviewed. The frequency of respiratory distress was 31% in infants of diabetic mothers, 2.6% in infants of prediabetic mothers, and 0.46% in all infants born at the same hospital during the same period. Neonatal mortality during the first month of life was 14% in the infants of diabetic mothers and 3.5% in the infants of prediabetic mothers. Both these rates for neonatal mortality are higher than those reported for live births in the United States and Minnesota between 1950 and 1965. Of the deaths in both groups combined, 77% occurred in the first 3 days of life in infants diagnosed as having respiratory distress. Birth weight and prematurity, gestational age, and toxemia were associated with an increased frequency of respiratory distress in the infants of prediabetic mothers, whereas gestational age, mode of delivery, and weight gain during pregnancy were so associated in infants of insulin-dependent diabetic mothers.