Pregnancy in women with Type 1 and Type 2 diabetes mellitus is associated with an increased risk of congenital malformations, perinatal mortality, obstetric complications and neonatal morbidity. Almost 17 years ago, the St Vincent's declaration was established, aiming to approximate the pregnancy outcome of diabetic women to that of the nondiabetic population, a goal designed to be achieved within 5 years. However, emerging and growing data suggest that, more than 15 years later, a poor pregnancy outcome exists among diabetic women in many Western European countries, even in medical centers of excellence. This review evaluates the causes of increased perinatal mortality in pregestational diabetes and suggests options for coping with this phenomenon.
- St Vincent