Diabetes in pregnancy: state of the art in the Mediterranean countries, Portugal.

In Portugal since 1980 the health care for diabetes in pregnancy has begun to be specialised and centralised, and the care is provided by multidisciplinary teams. At present there are eight diabetic teams in the main cities in the North, Centre and South of the country: three in Oporto, two in Coimbra, two in Lisbon and one in Almada. In our Center of the University Hospital, Coimbra, from 1980 to 1992 neonatal mortality dropped from 110/1000 to near 0/1000, macrosomia from 55% to 20%, neonatal hypoglycemia from 28% to 5.6%, RDS from 26% to 2.5%, congenital malformation from 9% to 2%. A "consensus on diabetes and pregnancy" to implement and give uniformity to health care was recently done (1996): a) criteria for pregnancy planning and management for pregestional diabetes (type 1 and 2) have been given; b) protocol of screening, diagnosis and management for gestational diabetes have been suggested; c) finally a recent (1995) epidemiologic report of a multicentric Portuguese survey has been reported.