N Engl J Med 304 (22): 1331 - 1334, 1981. doi: 10.1056/NEJM198105283042204 Key Points Diabetes in pregnancy increases risk of fetal macrosomia, shoulder dystocia, preeclampsia, cesarean delivery, stillbirth, and, if preexisting or gestational diabetes is poorly controlled during organogenesis, major congenital malformations and spontaneous abortion.