Impact of Preconception Counseling On Awareness and Pregnancy Planning Among Women With Pregestational Diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 806-823-Gestational Diabetes
Basic/Clinical
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-806
Monika Pawlowska1, Julie Lee*2, Reena Khurana3, Christopher Mahony3, Marshall Dahl1, Jason M Kong1 and David Thompson1
1University of British Columbia, Vancouver, BC, Canada, 2Royal Columbian Hospital, New Westminster, BC, Canada, 3University of British Columbia, Surrey, BC, Canada
Women with pregestational diabetes have a higher frequency of miscarriage and congenital malformations because hyperglycemia in early pregnancy is teratogenic (1). With proper preconception care aimed at optimizing glycemic control, these adverse outcomes can be minimized (2).  Preconception counseling should be provided to all eligible women in order to educate and encourage them to seek out preconception care.

This study aimed to determine whether preconception counseling was associated with increased patient awareness of the risks of early pregnancy hyperglycemia and if this knowledge improved pregnancy planning.

We surveyed pregnant women with pregestational diabetes attending antenatal diabetes in pregnancy clinics around Vancouver, Canada, about the preconception counseling received from their regular physicians and how this impacted their behavior.

Of 54 women surveyed, 40 (74%) had received preconception counseling at least once.  Of the women counseled, 85% were aware that hyperglycemia in early pregnancy could be harmful to their baby, compared with 64% of women who were not counseled, however this difference was not statistically significant (p = 0.098).  Patients who were aware of the risks were more likely (70%) to discuss their intentions to get pregnant with their doctor than those who were not aware (45%), however, this difference was not statistically significant (p = 0.132). Of all women surveyed, 63% chose their family doctor as the most likely physician they would discuss their pregnancy intentions with.  Only 31% of the women chose an endocrinologist, even though 46% had one.  Finally, awareness was associated with a higher frequency of contraceptive use (58% vs. 36%) when pregnancy was not desired, but again statistical significance was not reached (p = 0.196).

This study showed a positive trend between preconception counseling and patient awareness of the risks of early pregnancy hyperglycemia.  There was also a positive association between awareness and pregnancy planning as evidenced by higher pregnancy disclosure rates and contraceptive use.  Conversely, it seems that a lack of awareness impedes pregnancy planning, therefore, preconception counseling should be incorporated into routine diabetes care.  This is particularly important at the primary care level, since the majority of women identified their family doctor as the physician they would most likely discuss pregnancy with.

(1) Macintosh Mary CM et al., British Medical Journal 2006; 333:177.  (2) Murphy Helen R et al., Diabetes Care 2010; 33:2514.

Nothing to Disclose: MP, JL, RK, CM, MD, JMK, DT

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

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