GPs are being urged to question women with diabetes or epilepsy about their plans for children to prevent placing unborn babies at risk.
New financial incentives have been published by the National Institute for Health and Care Excellence to encourage family doctors to target women in their childbearing years.
Under the plans, doctors will be asked to note the percentage of women with diabetes who are aged 17 or over, but under 45, who have been given advice in the previous year about contraception, conceiving and pregnancy.
Official data from the Centre for Maternal and Child Enquiries (CMACE) suggests women with Type 1 or Type 2 diabetes have a “significantly increased risk of adverse pregnancy outcomes” compared to other women.
This includes a risk of stillbirth which is five times higher, an increased risk of the baby dying and a two-fold increased risk of congenital abnormalities.
These are caused by diabetes itself, lifestyle factors such as being overweight, but also side effects of the medications used to treat diabetic complications.
Establishing good blood sugar control before conception and continuing throughout pregnancy will reduce the risk of miscarriage, stillbirth, death and abnormalities, according to the new indicator.
Another indicator covers women with epilepsy who are aged 18 or over, but under 45, who are taking anti-epileptic drugs.
They will be offered information and counselling about contraception, conception and pregnancy.
Anti-epileptic drugs taken during pregnancy are associated with an increased risk of major congenital abnormalities.
Women in the general population have a 1 or 2 per cent chance of having a baby with such abnormalities, increasing to just over 3.5 per cent for women on one epilepsy drug and 6 per cent for women taking two or more.
Research suggests only 46 per cent of women with epilepsy who have had children were told before conceiving or during pregnancy that their medication might affect their unborn child.
The indicators, which are subject to consultation, have been developed for the 2014-15 Quality and Outcomes Framework (QOF), which rewards GPs financially for protecting the health of their patients.
Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “These proposed new indicators for family doctors will help set high standards of care and improved results for patients.”