title: Preconception counseling in women with diabetes: a population-based study in the north of England.
abstract: OBJECTIVE To investigate the association of preconception counseling with markers of care and maternal characteristics in women with pregestational diabetes. RESEARCH DESIGN AND METHODS The study includes data from a regional multi-center survey on 588 women with pregestational diabetes who delivered a singleton pregnancy between 2001 and 2004. Logistic regression was used to obtain crude and adjusted estimates of association. RESULTS Preconception counseling was associated with better glycemic control 3 months preconception (odds ratio 1.91, 95% CI 1.10-3.04) and in the first trimester (2.05, 1.39-3.03), higher preconception folic acid intake (4.88, 3.26-7.30), and reduced risk of adverse pregnancy outcome (P = 0.027). Uptake of preconception counseling was positively associated with type 1 diabetes (1.87, 1.14-3.07) and White British ethnicity (2.56, 1.17-5.6) and negatively with deprivation score (0.78, 0.70-0.87). CONCLUSIONS Efforts are needed to improve preconception counseling rates. Uptake is associated with maternal sociodemographic characteristics.
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA. avnish.tripathi@uscmed.sc.edu
authors.forename: Avnish
authors.initials: A
authors.lastname: Tripathi
authors.forename: Judith
authors.initials: J
authors.lastname: Rankin
authors.forename: Joan
authors.initials: J
authors.lastname: Aarvold
authors.forename: Colin
authors.initials: C
authors.lastname: Chandler
authors.forename: Ruth
authors.initials: R
authors.lastname: Bell
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003376:Counseling / Q000379:methods* / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D011153:Population; D016742:Preconception Care / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011254:Pregnancy in Diabetics / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult