title: Congenital abnormalities and pregestational diabetes mellitus in pregnancy.
abstract: Despite falling perinatal mortality rate, congenital malformation remains the major cause of mortality in infants of mothers with established diabetes. The perinatal mortality rate in this group of infants is 5 times the overall perinatal mortality rate in this hospital. It is well established that pre-pregnancy counselling and maintenance of euglycaemia during the periconception period are the keys to prevention of congenital malformation. We are able to offer pre-pregnancy counselling to 29% of our diabetic mothers who are diagnosed to have pregestational diabetes mellitus only after the 6 weeks postnatal oral glucose tolerance test. Even in the known established diabetes mellitus, 95% of the patients were first seen after the period of organogenesis (> 8 weeks). This could explain our high congenital malformation rate of 15.7%.
authors.affiliation: Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
authors.forename: Y T
authors.initials: YT
authors.lastname: Chia
authors.forename: S
authors.initials: S
authors.lastname: Chua
authors.forename: A C
authors.initials: AC
authors.lastname: Thai
authors.forename: L P
authors.initials: LP
authors.lastname: Kek
authors.forename: S S
authors.initials: SS
authors.lastname: Ratnam
mesh_terms: D000328:Adult; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology