An infant born to a mother with diabetes is at an increased risk for malformations. This risk can be reduced by attention to a number of factors. It is important to start preventive measures as soon as possible for a woman contemplating a pregnancy in order to minimize harm to the fetus.

Factors Contributing to Malformations

Preventive Measure

uncontrolled hyperglycemia, typically associated with an elevated HgbA1c

keep HgbA1c below 8.5% while avoiding hypoglycemic episodes

medications with teratogenic potential

avoid any medication that has not been cleared for pregnancy (some oral hypoglycemic agents, statins, ACE inhibitors, ARBs. etc)

folate deficiency

provide adequate folate supplementation during the pregnancy

lack of preconception care

proper preconception management

family history of hereditary disorder in woman or partner

complete family history and genetic counseling

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