INSULIN-DEPENDENT DIABETES IN PREGNANCY - IMPACT OF MATERNAL BLOOD-GLUCOSE CONTROL ON THE OFFSPRING

Definition of optimal glycaemic control in diabetic pregnancy may stil l be debated. Measures of glucose control (based on 4-6 daily glucose and frequent HbA1c values) were recorded in two series of diabetic pre gnancies; one multicentre study (n = 92, 1979-82), and one study from our own institution (n = 113, 1983-85). The average pregnancy glucose levels were 5.9 mmol/L (third trimester only) and 6.5 mmol/L (all trim esters), respectively. Discriminant analysis (including pregnancy gluc ose, HbA1c, gestational age, diabetes duration and hypertension) revea led that gestational age only (first series) and gestational age and H bA,c independently of each other (second series) were significantly as sociated with the occurrence of severe neonatal morbidity present amon g 30 and 16.8% of the infants, respectively. The overall outcome was f avourable. The findings of no perinatal mortality, normal premature de livery rate (8.9%) and a very low rate of severe maternal hypoglycaemi a (4.4%) in series two support the feasibility of a strict but individ ualized management programme.