EFFICACY OF PRECONCEPTION CARE OF DIABETIC WOMEN IN A COMMUNITY SETTING

OBJECTIVE: To determine the impact of informal preconception care of d iabetic women on first-trimester glycemia control in a community setti ng. STUDY DESIGN: Forty-five women with pregestational diabetes underw ent a standardized interview regarding their preconception cave prior to the index pregnancy. Patients tinder 14 weeks' gestation had their glycosylated hemoglobin measured; it teas used as an index of control. Variables related to glycemic control were analyzed with reference to glycosylated hemoglobin results. RESULTS: Despite a high incidence of counseling and frequent preconception visits, the mean first-trimeste r glycosylated hemoglobin (+/-SD) was high (10.7+/-2.0), and the major ity of pregnancies were unplanned. CONCLUSION: Informal and noncentral ized preconception care was not effective in preventing first-trimeste r hyperglycemia in this group of diabetic women. A high rate of unplan ned pregnancy and lack of structured preconception care were prevalent and possibly etiologic.