Murphy HR, Howgate C, O'Keefe J, et al. - Given the correlation of diabetes in pregnancy with preterm delivery, birthweight extremes, and increased rates of congenital anomaly, stillbirth, and neonatal death, researchers conducted a national population-based cohort study with the aim to determine and compare modifiable risk factors linked with adverse pregnancy outcomes in women with type 1 diabetes and those with type 2 diabetes. In addition, they identified effective maternity clinics. In the first 5 years of the National Pregnancy in Diabetes audit across 172 maternity clinics in England, Wales, and the Isle of Man, UK, they identified 17,375 pregnancy outcomes in 15,290 pregnant women for inclusion in this study. Of these pregnancies, 8,690 (50·0%) were in women with type 1 diabetes (median age at delivery 30 years, median duration of diabetes 13 years) and 8,685 (50·0%) were in women with type 2 diabetes (median age at delivery 34 years, median duration of diabetes 3 years). Outcome data suggest that women with type 1 or type 2 diabetes persistently experienced adverse pregnancy outcomes. The key modifiable risk factors identified were maternal glycaemia and BMI. Appreciably better outcomes were not observed for any of the maternity clinics when compared with others, suggesting the necessity for changes in health-care system across all clinics.