Congenital malformations in infants of diabetic mothers.

DURING the last two decades the outcome of pregnancy in the diabetic has improved greatly. In the Royal Maternity Hospital, Belfast, for example, the total fetal loss and perinatal mortality during the years 1972-78 have been 4.3 and 3.2 per cent respectively, whereas in earlier years figures well in excess of 10 per cent were common everywhere. In view of this the contribution of congenital malformations is assuming increasing importance as a factor in the survival of infants of diabetic mothers. Over the years the occurrence of congenital malformation in diabetic pregnancies has been the subject of some controversy but it is now generally accepted that the incidence is about two to four times greater than in the general population. The purpose of this paper is to record the incidence of congenital malformations in infants of diabetic mothers born in the Royal Maternity Hospital, Belfast, during the years 1963 to 1978 inclusive, to assess their contribution to perinatal mortality and to consider ways in which this risk could be reduced.