title: Effect of implementation of a preconception counselling resource for women with diabetes: A population based study.
abstract: To evaluate the effect of regional implementation of a preconception counselling resource into routine diabetes care on pregnancy planning indicators.
  
  
  
  A preconception counselling DVD was distributed to women by diabetes care teams and general practices. Subsequently, in a prospective population-based study, pregnancy planning indicators were evaluated. The post-DVD cohort (n=135), including a viewed-DVD subgroup (n=58), were compared with an historical cohort (pre-DVD, n=114). Primary outcome was HbA1c at first diabetes-antenatal visit. Secondary outcomes included preconception folic acid consumption, planned pregnancy and HbA1c recorded in the 6 months preconception.
  
  
  
  Mean first visit HbA1c was lower post-DVD vs. pre-DVD: 7.5% vs. 7.8% [58.4 vs. 61.8mmol/mol]; p=0.12), although not statistically significant. 53% and 20% of women with type 1 and 2 diabetes, respectively, viewed the DVD. The viewed-DVD subgroup were significantly more likely to have lower first visit HbA1c: 6.9% vs. 7.8% [52.1 vs. 61.8mmol/mol], P<0.001; planned pregnancy (88% vs. 59%, P<0.001); taken folic acid preconception (81% vs. 43%, P=0.001); and had HbA1c recorded preconception (88% vs. 53%, P<0.001) than the pre-DVD cohort.
  
  
  
  Implementation of a preconception counselling resource was associated with improved pregnancy planning indicators. Women with type 2 diabetes are difficult to reach. Greater awareness within primary care of the importance of preconception counselling among this population is needed.
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. Electronic address: v.holmes@qub.ac.uk.
authors.forename: V A
authors.initials: VA
authors.lastname: Holmes
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
authors.forename: L L
authors.initials: LL
authors.lastname: Hamill
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
authors.forename: F A
authors.initials: FA
authors.lastname: Alderdice
authors.affiliation: School of Biological Sciences, Queen's University Belfast, Belfast, UK.
authors.forename: M
authors.initials: M
authors.lastname: Spence
authors.affiliation: Ulster Hospital, South Eastern Health and Social Care Trust, Dundonald, UK.
authors.forename: R
authors.initials: R
authors.lastname: Harper
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
authors.forename: C C
authors.initials: CC
authors.lastname: Patterson
authors.affiliation: Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK.
authors.forename: S
authors.initials: S
authors.lastname: Loughridge
authors.affiliation: Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK.
authors.forename: S
authors.initials: S
authors.lastname: McKenna
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gough
authors.affiliation: Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: McCance
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003376:Counseling; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D005193:Family Planning Services; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005492:Folic Acid / Q000008:administration & dosage; D006442:Glycated Hemoglobin / Q000378:metabolism; D006295:Health Resources; D006801:Humans; D050498:Live Birth; D009660:Northern Ireland; D010353:Patient Education as Topic; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D015397:Program Evaluation; D011446:Prospective Studies; D012040:Regional Health Planning; D018570:Risk Assessment; D012307:Risk Factors; D014741:Video Recording; D014803:Vitamin B Complex / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005492:Folic Acid; D006442:Glycated Hemoglobin; D014803:Vitamin B Complex; C517652:hemoglobin A1c protein, human
keywords: Diabetes Pregnancy ‘Preconception counselling’ education