When the pregnancy audit started in 1993 England was split for administrative purposes into various health regions. The region forming the north east England and Cumbria was the Northern Region, a strict geographical area with a population of about 3 million. Collaboration between the consultant physicians and obstetricians had been established for many years. The project was piloted for 6 months and has since been collecting outcome data of all diabetic pregnancy within the former region. Diabetic pregnancy is defined for this audit as pregnancy in women known to have diabetes prior to pregnancy. Most women have Type 1 diabetes. All women with diabetic pregnancy within the region and their outcomes were followed up. In England the definition of stillbirth is a gestation age of 24 weeks.