Pregnancy in diabetic women.

Pregnancy in 207 diabetic women managed at a diabetic antenatal unit over a six-year period (1970 to 1976) resulted in a perinatal mortality of 16 (7-8%). One hundred and fifty-nine women (70%) were receiving insulin before pregnancy and 20% had evidence of diabetic microangiopathy. Still birth was twice as frequent as neonatal death, and severe respiratory distress syndrome was uncommon, resulting in only one death. Bad control of diabetes was associated with a poor prognosis. This was contributed to be lack of cooperation, anxiety and poor knowledge of diabetes. The accurate assessment of gestation and maturity, the monitoring of fetal-placental function, careful blood glucose level control, and an understanding of neonatal physiology have contributed to a reduction in fetal mortality. Close cooperation between an obstetrician, physician and neonatal pediatrician experienced in the problems encountered in the management of pregnant diabetic women is essential if the best results are to be obtained.