A Florida public health-based endocrine clinic for low-income pregnant women with diabetes.

Abstract

To evaluate pregnancy outcomes of low-income women with diabetes-complicated pregnancies who received care from an embedded, public health-based endocrine specialty clinic (ESC) in Florida. This program evaluation used retrospective chart data to analyze client characteristics, pre-program and during-program glycemic control, and pregnancy outcomes of women enrolled in a prenatal ESC. Ninety-two low-income, pregnant women with type 1/type 2 diabetes or gestational diabetes (GDM) comprised this racially/ethnically diverse sample. Neonatal outcomes included frequencies of prematurity, hypoglycemia, hyperbilirubinemia, and birth weight-for-gestational-age categories. Differences in maternal HbA1C at program entry and mean HbA1C during ESC care were determined by a Wilcoxon and paired sample t test. HbA1C levels during ESC care (6.9±1.4) were less than program entry HbA1C levels (7.9±1.8) for women with pregestational diabetes (Z=-3.364, p=.001). Among women with GDM, mean HbA1C values during ESC care (5.5±0.4) did not significantly differ (t(51)=-0.532, p>.05) from program entry HbA1C levels (5.5±0.5), suggestive of glycemic goal achievement. No neonatal hypoglycemia or hyperbilirubinemia cases were observed in both groups. Approximately 11% of births were preterm, and 16% of neonates were large-for-gestational-age. A public health-based ESC for low-income pregnant women with diabetes may positively affect pregnancy outcomes.