Overt diabetes in pregnancy.

Of 45 diabetic pregnancies, 80% were Class C, D, or R. The perinatal mortality rate was 4.4% (corrected 2.2%); however, neonatal morbidity was high. Of the infants, 28% developed respiratory distress syndrome (RDS); 18%, asphyxia; and 42%, hypoglycemia. Thus, the woman with overt diabetes needs delivery in an institution where neonatal expertise and modern neonatal facilities exist. Of the mother 28% had a family history that was negative for diabetes mellitus. Four neonates developed RDS despite mature lecithin/sphingomyelin ratios.