title: Pregnancy planning in type 1 diabetic women improves glycemic control and pregnancy outcomes.
abstract: OBJECTIVE
  Pregnancy in women with type 1 diabetes is associated with increased risks. The aim of this study was to evaluate the effect of pregnancy planning on outcomes of type 1 diabetic pregnancies.
  
  
  METHODS
  We retrospectively assessed pregnancy outcomes of type 1 diabetic women who were patients of Diabetes Clinic of North Karelia hospital between 2000 and 2012. We evaluated the medical records of 73 women experiencing 145 pregnancies and data of their infants.
  
  
  RESULTS
  Altogether 96 (66.2%) pregnancies were planned. HbA1c levels were significantly lower before and during the whole pregnancy when pregnancy was planned than if it was not planned (all p <0.001). Planned pregnancies resulted in significantly fewer congenital anomalies (p <0.001). Pregnancy planning reduced the age-adjusted risk of Cesarean sections (OR 0.25, p = 0.021). Pregnancy planning was associated with a reduced risk of adverse pregnancy outcomes (including miscarriages and congenital anomalies). This association was independent of age, HbA1c before pregnancy, smoking, hypertension, microvascular complications, and thyroid disease (OR 0.26; 95% CI 0.09, 0.76).
  
  
  CONCLUSIONS
  Pregnancy planning is beneficial for glycemic control and pregnancy outcomes of type 1 diabetic women. The benefit of pregnancy planning was independent of other risk factors for adverse pregnancy outcomes.
authors.affiliation: a Department of Internal Medicine , Hospital District of North Karelia , Joensuu , Finland .
authors.forename: Päivi
authors.initials: P
authors.lastname: Kekäläinen
authors.affiliation: b Department of Pediatrics , Hospital District of North Karelia , Joensuu , Finland .
authors.forename: Mari
authors.initials: M
authors.lastname: Juuti
authors.affiliation: c Department of Obstetrics and Gynecology , Hospital District of North Karelia , Joensuu , Finland .
authors.forename: Tiina
authors.initials: T
authors.lastname: Walle
authors.affiliation: d Institute of Public Health and Clinical Nutrition, University of Eastern Finland , Kuopio , Finland .|e Hospital District of North Karelia , Joensuu , Finland , and.|f Department of Chronic Disease Prevention , National Institute for Health and Welfare , Helsinki , Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D016742:Preconception Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood / Q000453:epidemiology*; D012189:Retrospective Studies
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Pregnancy; pregnancy outcome; pregnancy planning; prepregnancy care; type 1 diabetes