title: [From adolescence to pregnancy: a model of multidisciplinary team support for future pregnant women].
abstract: The frequency and severity of maternal and neonatal complications of diabetes are strongly related to the degree of metabolic control. The major goal of therapeutic management of the diabetic mother requires the achievement of euglycaemia during the pre- and peri-conceptional periods, during pregnancy until delivery. Besides the need for frequent and individualized insulin dose adjustment, the patient's adhesion to the treatment, with the constraints it implies, is directly related to the prognosis of pregnancy for the mother and the newborn. An extended longitudinal follow-up allows the patient to become familiar with the multidisciplinary specialist team who will be in charge of her pregnancy. This condition seems a prerequisite to the completion of a form of reciprocal "contract of confidence" in order to strengthen the motivation of the mother and make more efficient the conditions of her supervision. The quality of metabolic control has been studied by retrospective analysis of the evolution of 32 pregnancies in 21 diabetic patients who received this form of longitudinal follow-up. The mean and median HbA1c measurements at childbirth, respectively 6.2 and 6.3%, seem to confirm the relevance of this model of longitudinal follow-up.
authors.affiliation: Service de Médecine Foeto-Maternelle, Centre Hospitalier Universitaire Brugmann, ULB, Bruxelles. avokaer@ulb.ac.be
authors.forename: Alain
authors.initials: A
authors.lastname: Vokaer
mesh_terms: D000293:Adolescent; D000328:Adult; D019468:Disease Management; D005260:Female; D006801:Humans; D010348:Patient Care Team; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011254:Pregnancy in Diabetics / Q000628:therapy*; D055815:Young Adult