The Frederick County medical editor accused of strangling his wife in January and leaving her body in a car near Baltimore-Washington International Airport pleaded guilty to first-degree murder yesterday and received a life sentence with all but 30 years suspended.

Frederick County Circuit Court Judge Julie R. Stevenson said she will recommend that Donald Wayne Holt, 45, serve the sentence at the Patuxent Institute, where he can receive treatment for severe diabetes and clinical depression.

It wasn't clear yesterday why Holt had an eleventh-hour change of heart. His trial was set to begin yesterday, and he had entered a plea of not guilty Tuesday and sat through two days of jury selection.

Maryland State Police had obtained a statement from Holt in which he admitted strangling his wife, Nancy A. Holt, 43, on Jan. 18. Donald Holt even drew police a map that led them to the silver 1995 Buick Regal in which Nancy Holt's decomposing body was found covered with a blanket on the floor of the back seat.

A spokesman for Nancy Holt's relatives said that they were satisfied with the sentence because it spared the couple's young children the painful publicity of a trial.

"It was mostly for the children's sake," Joe Ignatius, Nancy Holt's brother-in-law, said after yesterday's brief sentencing.

Ignatius was less pleased with the statement Holt made yesterday to the standing-room-only crowd of about 80 people packed into the courtroom.

Holt said he is "profoundly sorry for the tragedy that has happened" and the suffering of his children and others but added, "I am a victim as well."

Dressed in a charcoal gray suit and crisp white shirt, Holt, a senior editor at the National Cancer Institute's scientific journal in Bethesda, said he hoped that a "lesson can be learned": that "we should put God first, family second and then . . . career thirdly." Ignatius said Holt was apparently blaming the problems in their marriage on his wife's career at the U.S. Health Care Financing Administration in Baltimore.

Police learned on Jan. 20 that Nancy Holt was missing when an out-of-state friend of hers said Donald Holt had called her and reported his wife was missing.

Investigators said they spoke that night to Donald Holt, who told them his wife had been missing since Jan. 18. They said he also told them she was supposed to have gone shopping that day and then had gone to work but failed to return. He also told police that he and his wife had been having some marital trouble and that she might have gone somewhere to "cool off," Deputy State's Attorney J. Charles Smith said yesterday.

After police learned that Donald Holt was at Carroll County General Hospital in Westminster and questioned him there, he admitted to the slaying and led them to the BWI parking lot.

Holt's defense attorneys entered and then withdrew a plea of insanity in the case. They sought unsuccessfully to have the statement taken at the hospital stricken, arguing it had been obtained illegally.

Holt's attorneys also tried unsuccessfully to win a change of venue arguing that intense publicity made it impossible to get a fair trial in Frederick County.

The plea deal leaves the reasons for Nancy Holt's murder murky. Donald Holt had made references to marital difficulties, and Nancy Holt's family has said she had been planning to ask her husband for a separation just before she was killed.

Meanwhile, Nancy Holt's parents are caring for the three children, male and female twins in seventh grade and a daughter in fourth grade.

"In a situation like this, you really can't understand it. We have lost our daughter, she can never be replaced," said Sylvester "Dutch" Adams.

Judge Stevenson was more harsh in her remarks to the seemingly implacable Holt. "It was your act" that caused the tragedy, she said. "There is no excuse or justification."

With that, she gaveled the session to a close, and Holt rose and politely shook his lawyers' hands.

Under Maryland law, Holt could be paroled in as few as 15 years, but prosecutors said inmates with life sentences are rarely granted parole.