Why Don't Women With Diabetes Plan Their Pregnancies?

Holing, Emily V.; Brown, Zane A.; Beyer, Carla Shaw; Connell, Frederick A.

doi:10.1097/00006254-199901000-00006

Cited by 45 publications

(74 citation statements)

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“…Our findings are consistent with other studies of pregnancy planning in women with diabetes, which report planning rates of 37-53% [11][12][13]. This study provides further evidence, using a validated and more comprehensive measure, that pregnancy planning is suboptimal in women with diabetes.…”

Section: Discussionsupporting

confidence: 91%

“…Other studies have shown that women with type 2 diabetes are less often cared for by diabetes specialists than women with type 1 diabetes [26], and therefore may have less opportunities for prepregnancy counseling and optimization of glycemic control. Also, factors such as income level, education, and employment were similar between the groups, which are important predictors of pregnancy planning [12,13]. Disparities may exist in other type 2 diabetes populations and may serve as greater barriers to pregnancy planning.…”

Section: Discussionmentioning

confidence: 86%

“…Despite good evidence for the importance of pregnancy planning in women with diabetes, studies suggest that only 37-53% of these women report having planned their pregnancies [11][12][13]. However, previous studies have not considered the graded and complex nature of pregnancy planning, which incorporates concepts such as intention to conceive, proceptive behavior, and timing [14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy planning in women with pregestational diabetes

Lipscombe¹,

McLaughlin²,

Wu³

et al. 2011

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy planning in women with pregestational diabetes

Lipscombe¹,

McLaughlin²,

Wu³

et al. 2011

The Journal of Maternal-Fetal & Neonatal Medicine

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“…This probably explains the high rate of planned pregnancies (84%) compared with other studies, in which percentages of 26% and 59% have been reported 36 37. The organisation of the Dutch healthcare system, which allows access to health care for everyone, may also have played a role.…”

Section: Discussionmentioning

confidence: 70%

Risk of complications of pregnancy in women with type 1 diabetes: nationwide prospective study in the Netherlands

Evers

Valk

Visser

2004

BMJ

663

443

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Objective To investigate maternal, perinatal, and neonatal outcomes of pregnancies in women with type 1 diabetes in the Netherlands. Design Nationwide prospective cohort study. Setting All 118 hospitals in the Netherlands. Participants 323 women with type 1 diabetes who became pregnant between 1 April 1999 and 1 April 2000. Main outcome measures Maternal, perinatal, and neonatal outcomes of pregnancy. Results 84% (n = 271) of the pregnancies were planned. Glycaemic control early in pregnancy was good in most women (HbA 1c ≤ 7.0% in 75% (n = 212) of the population), and folic acid supplementation was adequate in 70% (n = 226). 314 pregnancies that went beyond 24 weeks' gestation resulted in 324 infants. The rates of pre-eclampsia (40; 12.7%), preterm delivery (101; 32.2%), caesarean section (139; 44.3%), maternal mortality (2; 0.6%), congenital malformations (29; 8.8%), perinatal mortality (9; 2.8%), and macrosomia (146; 45.1%) were considerably higher than in the general population. Neonatal morbidity (one or more complications) was extremely high (260; 80.2%). The incidence of major congenital malformations was significantly lower in planned pregnancies than in unplanned pregnancies (4.2% (n = 11) v 12.2% (n = 6); relative risk 0.34, 95% confidence interval 0.13 to 0.88). Conclusion Despite a high frequency of planned pregnancies, resulting in overall good glycaemic control (early) in pregnancy and a high rate of adequate use of folic acid, maternal and perinatal complications were still increased in women with type 1 diabetes. Neonatal morbidity, especially hypoglycaemia, was also extremely high. Near optimal maternal glycaemic control (HbA 1c ≤ 7.0%) apparently is not good enough.

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“…miscarriage, major congenital abnormality or perinatal death) 11 , 12. A key finding of a qualitative study of women with diabetes was that those with planned pregnancies generally described an ongoing positive relationship with their healthcare providers 13. By comparison, women who felt that their doctors discouraged pregnancy were more likely to have an unplanned pregnancy 13.…”

Section: What Are the Risks?mentioning

confidence: 99%