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• W4200021559 abstract "The aim of our study was to ascertain the adequacy of preconception (PC) and postpartum (PP) care in a cohort of women with preexisting diabetes (PED) as measured against American College of Obstetrics and Gynecology and American Diabetes Association (ADA) recommendations. We performed a secondary analysis of 72 women with PED from a previously published cohort study of 4,144 deliveries between May 2016 and July 2017. Women with known PED or newly diagnosed PED (early pregnancy HbA1c ≥ 6.5%) were included. We determined the proportion of women with known PED who received comprehensive PC diabetes care and the proportion with newly diagnosed PED who had a missed opportunity for PC diabetes screening. Frequency of contraception use and follow up PP and diabetes care, as well as subsequent pregnancy HbA1C were reported for the entire cohort. We also compared obstetric and neonatal outcomes between groups. T-tests and Chi-squared tests were performed for categorical measures where sample sized allowed. In women with known PED (n=48), 69% received comprehensive diabetes care prior to pregnancy, but only 12% received PC counseling. In those with newly diagnosed PED, 100% (n=24) met ADA criteria for screening, but only 29% (n=7) had a primary care visit during the 12 months preceding pregnancy. In the entire cohort, 96% of women had PP contraception counseling and 97% had documented PP contraception use, with long-acting methods being the most popular. Only 64% of our cohort had follow-up for diabetes care within 3-months PP. In the 17 patients with a repeat pregnancy after the original data was published, mean HbA1c at entry to care was higher (9.06%) than our original cohort (7.59%). Targeted interventions focusing on diabetes management and preconception counseling for women with known PED and diabetes screening for those with risk factors prior to pregnancy, as well as diabetic control PP, are needed to improve the quality care at our institution.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
• W4200021559 created "2021-12-31" @default.
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• W4200021559 date "2022-01-01" @default.
• W4200021559 modified "2023-10-18" @default.
• W4200021559 title "Preconception and postpartum care in women with preexisting diabetes: Opportunities for quality improvement" @default.
• W4200021559 doi "https://doi.org/10.1016/j.ajog.2021.11.993" @default.
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