*1.2.3.1 Fetal and infant mortality*

In past years, the rate of infant mortality from diabetic mothers has been significantly high. But nowadays, due to advances in medical and obstetrical management in the pregnancy period, this rate has decreased significantly. But despite these advances, the mortality rate in these infants is still reported to be 3 to 10 times higher than in infants under normal pregnancy conditions, as well as the prevalence of congenital malformations is 4 to 10 times higher than that of healthy mothers [29, 33]. Studies show that fetal malformations are the reason 30 to 40 percent of infant deaths in diabetic mothers. However, it has been clearly shown that precise control of blood glucose during pregnancy reduces maternal and neonatal mortality [59, 60].

### *1.2.3.2 Neonatal hypoglycemia*

A sharp drop in plasma glucose concentration after delivery is a characteristic feature of newborns born to poorly controlled diabetic mothers. This event occurs due to chronic maternal hyperglycemia resulting in fetal pancreatic cell hyperplasia. Subsequently, this hyperplasia causes stimulation of fetal pancreatic beta cells to release a high level of insulin. In addition to stimulating somatic growth, hyperinsulinemia is also one of the main causes of hypoglycemia in the first few minutes after birth [24, 49].
