title: The effect of pre-pregnancy counselling for women with pre-gestational diabetes on maternal health status.
abstract: OBJECTIVE
  To assess the impact of pre-pregnancy counselling (PPC) on the health of diabetic women in early pregnancy as compared to their health at the time of PPC.
  
  
  METHODS
  Retrospective cohort study involving all the diabetic women who attended PPC and subsequently become pregnant in the decade 1997-2007. The proforma had two sections: one for the PPC visit and one for the booking visit. Details on demographic factors, control and complications of diabetes, folic acid, current medication, weight, contraception, smoking and alcohol consumption were documented.
  
  
  RESULTS
  Fifty-seven women who became pregnant after PPC were studied. There was optimisation of diabetic control with a significant reduction in HbA1c levels at booking as compared to PPC (7.5% vs 8.8%, p<0.0001). Diabetic surveillance (retinopathy and nephropathy screening) was up to date at the time of booking in >80% of the cases. Alteration of insulin regimes was undertaken in ∼ 1 in 5 women. Folic acid was taken by most patients (48/54) at booking. There was no significant reduction in the number of women who smoked at booking compared to PPC.
  
  
  CONCLUSIONS
  The effect of PPC was evident in the improvements in the markers of health of diabetic women in early pregnancy compared to at the time of PPC.
authors.affiliation: Department of Obstetrics, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ, United Kingdom. ayeshakashif1@hotmail.com
authors.forename: Ayesha
authors.initials: A
authors.lastname: Anwar
authors.forename: Amira
authors.initials: A
authors.lastname: Salih
authors.forename: Ewan
authors.initials: E
authors.lastname: Masson
authors.forename: Belinda
authors.initials: B
authors.lastname: Allen
authors.forename: Linda
authors.initials: L
authors.lastname: Wilkinson
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Lindow
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000517:prevention & control; D005492:Folic Acid / Q000008:administration & dosage; D006442:Glycated Hemoglobin / Q000032:analysis; D006293:Health Promotion / Q000379:methods; D006304:Health Status; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008499:Medical Records; D010349:Patient Compliance; D010353:Patient Education as Topic; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D012189:Retrospective Studies; D012648:Self Care; D012907:Smoking / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005492:Folic Acid; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human