Timing of birth
Women with pre-gestational diabetes are likely to birth at an earlier
gestation due to concerns over the increased risk of perinatal
mortality.7,29 Current guidelines recommend elective
delivery of women with pre-existing diabetes at 37+0to 38+6 gestation in order to prevent these
complications.30 It seems that clinicians were
initially eager to embrace interventions which may facilitate safer
earlier birth to avoid the increased risk of stillbirth in this
population,31 but with increasing scientific data on
the potential long term impacts of ACS in the early term period
published in the second half of the study period,32,33clinicians were more cautious in their approach.