Prospective studies of pre-conception diabetes care have confirmed its posi
tive impact on the incidence of malformations by improving glycaemic contro
l. Less information is available on the impact of preconception care on mat
ernal and neonatal morbidity. This audit addresses its impact on timing and
mode of delivery, incidence of macrosomia and rate of admission to neonata
l unit care in addition to sociodemographic factors which may influence att
endance at such a service. Attenders were more likely to be in a stable rel
ationship and be nonsmokers. They were more likely to book for antenatal ca
re earlier and with a lower glycated haemoglobin. There were no early deliv
eries (i.e. <30 weeks) or small for gestational age (SCA) babies in those w
ho attended for pre-conception care and no neonatal deaths. Admission to NN
U care was reduced by 50% in those who attended for preconception care. Alt
hough the rate of macrosomia was reduced, there was no impact on the Caesar
ian section rate. A pre-conception diabetes clinic may have a positive impa
ct on neonatal morbidity.