Sir.—The improved care of diabetic women prior to conception and during pregnancy has significantly decreased the incidence of mortality, morbidity, and congenital anomalies in the infants of these diabetic mothers.1-3 However, postnatal complications still occur more frequently among these infants than among infants of nondiabetic mothers.4-8 The significance of these complications for the developing child of the diabetic mother must be established to determine whether the complications at birth predispose these children to later neurodevelopmental dysfunction.
An analysis of the results of follow-up studies of children whose mothers had diabetes during pregnancy should address this issue. Results of five major follow-up studies have been published between 1977 and 1988.9-13 However, the results have often been contradictory and limited by methodologic flaws. For example, only two of the studies employed control groups.12,13 In all the studies, sample sizes were relatively small (73 to 174 children)