The relationship between pre-pregnancy care and early pregnancy loss, major congenital anomaly or perinatal death in type I diabetes mellitus

• Published in: BJOG : an international journal of obstetrics and gynaecology 2007, Vol.114 (1), p.104-107
• Main Authors: PEARSON, D. W. M, KEMAGHAN, D, LEE, R, PENNEY, G. C
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous - etiology; Adult; Biological and medical sciences; Congenital Abnormalities - etiology; Diabetes Mellitus, Type 1 - therapy; Diabetes. Impaired glucose tolerance; Diseases of mother, fetus and pregnancy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fetal Death - etiology; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Patient Care Planning; Preconception Care - methods; Pregnancy; Pregnancy in Diabetics - therapy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Regression Analysis
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2006.01145.x

The relationships between markers of pregnancy planning and pre-pregnancy care and adverse outcomes (early pregnancy loss, major congenital anomaly and perinatal death) were examined in 423 singleton pregnancies in women with pre-gestational type I diabetes mellitus. Pregnancy planning and markers of pre-pregnancy care were associated with reduced risks of adverse pregnancy outcomes. 'Documentation of achievement of an optimal haemoglobin A1c prior to discontinuation of contraception' was the marker associated with the lowest rate of adverse outcome (OR 0.2; 95% CI 0.06-0.67) and might serve as an appropriate definition of pre-pregnancy care for research and audit purposes.