The challenges in developing a dedicated pre-pregnancy clinic

Abstract

It has been well established that sub-optimal glycaemic control at conception and during early pregnancy is associated with increased fetal loss and congenital abnormalities in the infants of women with established diabetes. There is compelling evidence demonstrating that if these women improve their glycaemic control prior to and during early pregnancy, the rate of these abnormalities can be reduced.

We undertook a survey of women attending a general diabetes service – in which only half of the women of reproductive age reported receiving advice specific to pre-pregnancy care. Following this, a dedicated pre-pregnancy clinic was established.

Attendance at this clinic has resulted in women attending the maternity services at an earlier gestation and with better glycaemic control than those who did not attend for pre-pregnancy care. Despite the availability of this care, the number of women availing themselves of it remains less than half of those attending the maternity service.

The challenge now is how to inform all women of reproductive age with diabetes about the importance of obtaining this care, and how to encourage attendance for pre-pregnancy care.

Keywords:

• diabetes mellitus
• pre-pregnancy care
• pre-pregnancy clinic
• education