It has been realised for many years that the infants
of diabetic mothers have notably high foetal and neonatal
mortality rates, the reasons for which remain obscure.
These infants tend to be large, puffy and hyperkinetic.
If they are delivered at term, the mortality rate is very
high. Even if pregnancy is terminated two or three weeks
earlier, the incidence of respiratory distress and of
pulmonary hyaline membrane syndrome is high.Typertrophy of the pancreatic islet cells in such
infants has been established (Driscoll, Benirschke and Curtis,
1960). Pederson (1952) considers that this is a result
of stimulation of the foetus by maternal hyperglycaemia.
There is evidence that these infants become hypoglycaemic
immediately after birth (Komrower, 1954; Farquhar, 1961).
Some evidence of adrenocortical disturbance is present
(Farquhar, 1958). There are also some indications of
acidosis (Ibid).This study was begun to investigate the possibility that
there might be a disturbance in lipid and lipoprotein
metabolism in these infants, since it is already known that
such a disturbance exists in the mothers (Albrink and Nan,
1958).Information about normal serum lipid concentrations
in blood, at birth and in the neonatal period, is limited
so that any study of the infants of diabetic mothers
necessitates a parallel study of infants of normal mothers.
In the course of obtaining blood specimens from so called
"normal infants ", a considerable number of samples were
obtained from infants whose mothers had various ante- ï_atal
complications. These were notably toxaemia and abortive
tendencies. The investigation has therefore been extended
to cover these groups.Obtainiir_ blood specimens was naturally a rather
erratic process, dependin_ entirely on the availability of
hospital staff. In order that the intervening periods
might be occupied constructively, certain subsidiary
investigations were begun.To supplement the earlier work in the Department of
Child Life and Health in this University by Dr. J. W. Farquhar
on adrenocortical disturbances in the infants of diabetic
mothers, a very limited investigation of the urinary
excretion of 17- ketosteroids and l7ketogenic steroids has
been made in newborn infants. Difficulties in obtaining
complete twenty -four hour urine collections are considerable.
The amount of blood necessary for studying serum cortico
steroid concentrations is prohibitive in infants. Therefore
only a small number of urinary steroid estimations were made.Finally some information has been collected on the
amino -acid content of urine and serum in the neonatal period
in both normal and abnormal infants.The scope of the work to be described in this thesis
may be summarised as follows:1. The estimation of serum lipid and lipoprotein lipid
concentrations in the cord blood of infants, including
those with both normal and abnormal pre- and post natal
histories. The term "lipid" includes total lipid, total
cholesterol, total esterified fatty acid and phospholipid.2. The estimation of serum lipid and lipoprotein lipid
concentrations in the first week of life in the infants
of diabetic mothers.3. The estimation of the concentrations of 17- ketosteroids
and 17- keto._,enic steroids excreted in the urine of normal
infants on the first day of life and of infants of diabetic
mothers during the first three days of life.4. A chromatographic investigation of amino acid patterns
in cord blood and in venous blood and urine during the
neonatal period in normal and some abnormal infants.The methods of chemical analysis used throughout the
investigation are given in Appendix I and the methods of
statistical analysis in Appendix II. Both appendices will
be found at the end of the thesis.General conclusions are drawn at the end of each
section and not at the end of the thesis