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.