期刊
DIABETES CARE
卷 33, 期 12, 页码 2514-2520出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc10-1113
关键词
-
资金
- Diabetes UK [BDA 06/0003197]
- National Institute for Health Research (NIHR) [PDF/08/01/036]
- National Institute for Health Research [PDF/01/036] Funding Source: researchfish
OBJECTIVE - To implement and evaluate a regional prepregnancy care program in women with type 1 and type 2 diabetes RESEARCH DESIGN AND METHODS - Prepregnancy care was promoted among patients and health professionals and delivered across 10 regional maternity units A prospective cohort study of 680 pregnancies in women with type 1 and type 2 diabetes was performed Primary outcomes were adverse pregnancy outcome (congenital malformation stillbirth or neonatal death) congenital malformation and indicators of pregnancy preparation (5 mg folic acid gestational age and A1C) Comparisons were made with a historical cohort (n = 613 pregnancies) from the same units during 1999-2004 RESULTS - A total of 181 (27%) women attended, and 499 women (73%) did not attend prepregnancy care Women with prepregnancy care presented earlier (6 7 vs 7 7 weeks P < 0 001) were more likely to take 5 mg preconception folic acid (88 2 vs 26 7% P < 0 0001) and had lower A1C levels (A1C 6 9 vs 7 6% P < 0 0001) They had fewer adverse pregnancy outcomes (1 3 vs 7 8%, P = 0 009) Multivariate logistic regression confirmed that m addition to glycemic control lack of prepregnancy care was independently associated with adverse outcome (odds ratio 0 2 [95% CI 0 05-0 89] P = 0 03) Compared with 1999-2004 folic acid supplementation increased (40 7 vs 32 5% P = 0 006) and congenital malformations decreased (4 3 vs 7 3% P = 0 04) CONCLUSIONS - Regional prepregnancy care was associated with improved pregnancy preparation and reduced risk of adverse pregnancy outcome in type 1 and type 2 diabetes Prepregnancy care had benefits beyond improved glycemic control and was a stronger predictor of pregnancy outcome than maternal obesity ethnicity or social disadvantage
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据