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h maternal characteristics (age, diabetes duration, deprivation, BMI) without substantial differences between maternity clinics. Our data highlight persistent adverse pregnancy outcomes in women with type 1 or type 2 diabetes. Maternal glycaemia and BMI are the key modifiable risk factors. No maternity clinics were had appreciably better outcomes than any others, suggesting that health-care system changes are needed across all clinics. None. None. An affordable pneumococcal conjugate vaccine (PCV) is needed to ensure sustaina

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