Diabetes Mellitus in Pregnancy.

Diabetes mellitus (DM) in pregnancy imposes increased risks for the pregnant person, fetus, and infant, which includes miscarriage, congenital anomalies, accelerated fetal growth, iatrogenic prematurity, preeclampsia, delivery-related trauma, cesarean section, neonatal hypoglycemia, and respiratory distress syndrome. Preconceptual counseling for people with type 1 or type 2 DM who are contemplating pregnancy includes education about these risks, and optimization of glucose control. Fetal screening early in pregnancy in persons with type 1 or type 2 DM allows for early diagnosis and therapy optimization. In addition, screening for gestational DM in the late second trimester is routine given that such pregnancies are also affected. The overall perinatal morbidity and mortality of pregnancies complicated by DM is substantially higher than in the general obstetric population, proportionate to the level of glucose control.