ABSTRACT
Diabetes mellitus during pregnancy is responsible for significant complications in the fetus and neonate. Risk is higher in pregestational diabetes, but also if pure gestational diabetes (GDM) is not recognized and well managed. A relationship has been established between the risk of malformations in GDM and maternal blood glucose level. Such risk also increases with maternal body mass index and when GDM is diagnosed during early pregnancy. Only 50% of births can be explained by causes such as intrauterine growth restriction, preeclampsia, acute asphyxia, intrauterine infection, or congenital malformation. The concept of excessive fetal growth has been expressed either by the word "macrosomia" or by the expression "large for gestational age". Fetal growth restriction is less often associated with maternal diabetes but has been reported in association with severe vascular complications of advanced diabetes and poor placental perfusion. Maternal diabetes during pregnancy, regardless of the type, is a risk factor for macrosomia or excessive fetal growth.
