This laboratory medicine guideline begins with preconception issues and proceeds through pregnancy identification, first and second trimester evaluation of fetal health, and delivery and initial evaluation of the newborn. While it defines the central laboratory medicine issues, it is not a comprehensive listing of all possible events or the medical evaluation that may be required. The recommendations are based on the consensus of expert contributors and their experience in their field of expertise. Some issues are not yet fully resolved, and may require examination at a later date. Among these unresolved issues are the dietary addition of folic acid, the emerging role of first trimester screening for fetal health to supplant at least a portion of second trimester screening, and the evaluation of the high risk infant at term as well as the evaluation of the newborn infant.