Preconception care in managed care: the translating research into action for diabetes study.
OBJECTIVE
This study was undertaken to examine the rates of preconception counseling in managed care for women with diabetes and associated patient and physician characteristics.


METHODS
Participants included women aged 18 to 45 years enrolled in a study of diabetes care in managed care. Women were asked if they recalled discussions regarding glucose control before conception (n = 236) and use of family planning until glucose control was achieved (n = 227). Hierarchical logistic regression models accounted for patient and physician characteristics.


RESULTS
Fifty-two percent of women recalled being counseled about glucose control and 37% recalled family planning advice. In adjusted models, patient age (years) (odds ratio [OR] 0.91, 95% CI 0.86-0.96) and body mass index (BMI) (kg/m2) (OR 0.96, 95% CI 0.93-0.99) remained significant predictors of glucose control counseling. Similarly, patient age (years) (OR 0.94, 95% CI 0.89-0.99) and BMI (kg/m2) (0.96, 95% CI 0.93-0.99) remained significant predictors of family planning counseling.


CONCLUSIONS
Preconception counseling rates for diabetic women are low and associated with younger age and lower BMI.
Kim
Catherine
C
Department of Internal Medicine, University of Michigan, Ann Arbor, Mich, USA.
Ferrara
Assiamira
A
McEwen
Laura N
LN
Marrero
David G
DG
Gerzoff
Robert B
RB
Herman
William H
WH
D000293:Adolescent; D000328:Adult; D003376:Counseling; D005193:Family Planning Services; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs / Q000592:standards*; D008427:Maternal Health Services; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016742:Preconception Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology