Receipt of preconception care among women with prepregnancy and gestational diabetes.

Abstract

To determine the extent of provision of preconception care among women with prepregnancy diabetes or women who develop gestational diabetes compared with women without diabetes and to examine the association between preconception care receipt and diabetes status, adjusting for maternal characteristics. Data were collected from women who completed the Pregnancy Risk Assessment Monitoring System questionnaire in 10 U.S. states (Hawaii, Maryland, Maine, Michigan, Minnesota, New Jersey, Ohio, Tennessee, Utah and West Virginia) in the period 2009 to 2010. Weighted, self-reported receipt of preconception care by diabetes status was examined. Multivariate logistic regression was used to identify the association between preconception care receipt and diabetes status. Overall, 31% of women reported receiving preconception care. Women with prepregnancy diabetes (53%) reported the highest prevalence of preconception care, while women with gestational diabetes and women without diabetes reported a lower prevalence (32 and 31%, respectively). In the adjusted model, there was no difference in reported preconception care receipt between women with gestational diabetes and women without diabetes (odds ratio 1.1, 95% CI 0.9, 1.3), while women with prepregnancy diabetes were significantly more likely to report receipt of preconception care (odds ratio 2.2, 95% CI 1.5, 3.3) than women without diabetes. Although all women of reproductive age should receive preconception care, it is vital that women with known risk factors, such as those with prepregnancy diabetes and with risk factors for gestational diabetes, are counselled before pregnancy to optimize maternal and infant health outcomes. It is encouraging that women with prepregnancy diabetes report receiving preconception care more often than women on average, but preconception care is still not reaching all women at high risk.