Maternal diabetes mellitus and risk of neonatal respiratory distress syndrome: a meta-analysis

  • Yan Li
  • Weijing Wang
  • Dongfeng ZhangEmail author
Review Article
Part of the following topical collections:
  1. Pregnancy and diabetes



The relationship between maternal diabetes mellitus (DM) and neonatal respiratory distress syndrome (RDS) has long been recognized, but the conclusions of this relationship were non-consistent. We conducted this meta-analysis to explore the association between maternal DM and the risk of neonatal RDS.


We searched PubMed and Web of Science databases for cohort or case–control studies related to the association of maternal DM and neonatal RDS risk up to 25 August 2018. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by the use of random effect model. Meta-regression was used to explore potential sources of between-study heterogeneity.


A total of 24 studies from 23 available articles were included in this meta-analysis. For the association between maternal DM and the risk of neonatal RDS, the pooled OR was 1.47 (95% CI 1.24–1.74), especially for cohort studies (1.39, 95% CI 1.17–1.65). The pooled OR of the risk of neonatal RDS was 1.57 (95% CI 1.28–1.93) for gestational diabetes mellitus (GDM) and 2.66 (95% CI 2.06–3.44) for pre-gestational diabetes mellitus (PGDM).


This meta-analysis suggests that maternal DM, including GDM and PGDM, is linked to an increased risk of neonatal RDS.


Epidemiology studies Maternal diabetes Meta-analysis Neonatal respiratory distress syndrome 


Author contributions

Li and Zhang conceived the study, participated in its design and coordination, and were involved in drafting the manuscript. Li and Wang carried out the literature search, data extraction, and interpretation of the data. Li, Wang, and Zhang reviewed and revised the manuscript critically for important intellectual content. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Not applicable.

Supplementary material

592_2019_1327_MOESM1_ESM.docx (18 kb)
Table S1 Results of meta-regression (DOCX 17 KB)
592_2019_1327_MOESM2_ESM.tif (7.1 mb)
Fig S1 Cumulative meta-analysis of maternal diabetes and the risk of neonatal respiratory distress syndrome (OR, odds ratio; CI, confidence interval; *low probability of delivery at term) (TIF 7229 KB)
592_2019_1327_MOESM3_ESM.tif (2.6 mb)
Fig S2 Forest plot of pre-gestational diabetes mellitus and the risk of neonatal respiratory distress syndrome. The size of gray box is positively proportional to the weight assigned to each study, which is inversely proportional to the standard error of the OR, and horizontal lines represent the 95% Cis (OR, odds ratio; CI, confidence interval; *low probability of delivery at term) (TIF 2671 KB)
592_2019_1327_MOESM4_ESM.tif (2.4 mb)
Fig S3 Funnel plot of relative risk (OR) for the analysis of the association between maternal diabetes and the risk of neonatal respiratory distress syndrome. Each dot represents a different study (SE, standard error) (TIF 2449 KB)
592_2019_1327_MOESM5_ESM.tif (2.1 mb)
Fig S4 Funnel plot of relative risk (OR) for the analysis of the association between gestational diabetes mellitus and the risk of neonatal respiratory distress syndrome. Each dot represents a different study (SE, standard error) (TIF 2194 KB)


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Epidemiology and Health Statistics, Public Health CollegeQingdao UniversityQingdaoChina

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