CCRN Neonatal Practice Test

The main idea is that infants of diabetic mothers have delayed lung development and surfactant production. When a mother has diabetes, fetal blood glucose is higher, which drives fetal insulin levels up. High insulin suppresses the maturation of type II pneumocytes and the production of surfactant, a substance that reduces surface tension in the alveoli. Without enough surfactant, the air sacs tend to collapse and the infant develops respiratory distress, especially after birth when breathing begins. This surfactant deficiency from delayed maturation is the primary reason for the increased risk of respiratory distress syndrome in these infants. Other options describe processes that don’t explain the reduced surfactant and delayed maturation, such as excess surfactant, premature ductal closure, or rapid lung fluid clearance.