Prepregnancy diabetes and risk of placental vascular disease.

M aternal diabetes before pregnancy is associated with adverse maternal and perinatal outcomes, including acquired hypertension during pregnancy (1–3). The maternal placental syndromes preeclampsia and abruption or infarction of the placenta (4) are also more prevalent in women with insulin resistance, diabetes, and the metabolic syndrome (3,5–8). We evaluated the risk of placental vascular disease in association with prepregnancy diabetes.