FACTORS INFLUENCING PRECONCEPTION CONTROL OF GLYCEMIA IN DIABETIC WOMEN

Background: Although periconceptional glycemic control directly impact s perinatal outcome for pregestational diabetic women, these women sti ll frequently enter pregnancy with suboptimal control of glycemia. Obj ectives: To determine how frequently diabetic women enter pregnancy wi th suboptimal glycemic control and to identify factors, associated wit h not achieving optimal periconceptual control of glycemia. Patients a nd methods: Pregestational diabetic women (n = 55) who attended the Ma ternal Fetal Medicine Faculty Practice or the Resident Medical Complic ations Obstetric Clinic, Magee Women's Hospital, Pittsburgh, Pa, were administered a brief questionnaire pertaining to periconceptional educ ation and control of glycemia. Levels of periconceptional hemoglobin A (1c) were measured in all patients, Results: Sixty-one percent of preg estational diabetic women presented for prenatal care with suboptimal control of their blood glucose levels (hemoglobin A(1c) measurement, > 0.08). Of the 55 diabetic women who participated in the questionnaire, 47 (86%) were under the care of a physician for their diabetes, 45 (8 2%) monitored their glucose level at least 3 times per day, 34 (60%) s tated that they had been advised to plan a pregnancy, and 29 (53%) sta ted that they had planned their pregnancies. Women who had not been ad vised to achieve target hemoglobin A(1c) levels were:more likely to en ter pregnancy with suboptimal control of their blood glucose levels (P =.02).Women who experienced prior complications with pregnancy were s ignificantly more likely to enter pregnancy with suboptimal control of their blood glucose levels (P=.02). Conclusions: Diabetic women frequ ently enter pregnancy with suboptimal control of glycemia. Women not a dvised to achieve target glucose or hemoglobin A(1c) levels were more likely to enter pregnancy with suboptimal control of glycemia.