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AIM: To evaluate the effect of regional implementation of a preconception counselling resource into routine diabetes care on pregnancy planning indicators. METHODS: A preconception counselling DVD was distributed to women by diabetes care teams and general practices. Subsequently, in a prospective population-based study, pregnancy planning indicators were evaluated. The post-DVD cohort (n=135), including a viewed-DVD subgroup (n=58), were compared with an historical cohort (pre-DVD, n=114). Primary outcome was HbA1c at first diabetes-antenatal visit. Secondary outcomes included preconception folic acid consumption, planned pregnancy and HbA1c recorded in the 6 months preconception. RESULTS: Mean first visit HbA1c was lower post-DVD vs. pre-DVD: 7.5% vs. 7.8% [58.4 vs. 61.8mmol/mol]; p=0.12), although not statistically significant. 53% and 20% of women with type 1 and 2 diabetes, respectively, viewed the DVD. The viewed-DVD subgroup were significantly more likely to have lower first visit HbA1c: 6.9% vs. 7.8% [52.1 vs. 61.8mmol/mol], P<0.001; planned pregnancy (88% vs. 59%, P<0.001); taken folic acid preconception (81% vs. 43%, P=0.001); and had HbA1c recorded preconception (88% vs. 53%, P<0.001) than the pre-DVD cohort. CONCLUSIONS: Implementation of a preconception counselling resource was associated with improved pregnancy planning indicators. Women with type 2 diabetes are difficult to reach. Greater awareness within primary care of the importance of preconception counselling among this population is needed.

Original publication

DOI

10.1016/j.pcd.2016.07.005

Type

Journal article

Journal

Prim care diabetes

Publication Date

02/2017

Volume

11

Pages

37 - 45

Keywords

Diabetes Pregnancy ‘Preconception counselling’ education, Abortion, Spontaneous, Adult, Biomarkers, Counseling, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Family Planning Services, Female, Fetal Death, Folic Acid, Glycated Hemoglobin A, Health Resources, Humans, Live Birth, Northern Ireland, Patient Education as Topic, Preconception Care, Pregnancy, Pregnancy in Diabetics, Program Evaluation, Prospective Studies, Regional Health Planning, Risk Assessment, Risk Factors, Video Recording, Vitamin B Complex, Young Adult