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tion and hypotension of mother, which can influence blood flow of fetus. High level insulin of IDM may resist the promotion effect of adrenal cortex hormone to PS synthesis Pathogenesis PS deficiency alveolar surface tension↑ alveolus collapse and pulmonary pliance↓ work at inspiration↑difficulty at alveolus opening tidal volume↓ alveolar ventilation↓ CO2 retention respiratory acidosis V/A↓ hypoxia metabolic acidosis Alveolar permeability↑ interstitium edema fibrin deposition in the inner surface of alveoli eosinphilic hyaline membrane gas diffusion disorder } Clinical manifestation Respiratory distress 2~6h after birth: ? dyspnea, cyanosis, flaring of alaenasi, inspirat