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Pre-conception care for women with diabetes: A public health issue

02 June 2016
10 min read
Volume 24 · Issue 6

Abstract

Pre-conception care is recognised to be an effective strategy for addressing many health behaviours, particularly for women with diabetes, who carry a higher risk of morbidity and mortality. However, there is a lack of evidence of the most effective approaches for promoting pre-conception health and encouraging women to access services. This article explores this challenging issue and suggests a number of strategies that health professionals may consider in relation to promoting health in this area.

Diabetes mellitus continues to be one of the most common pre-existing medical conditions to complicate pregnancy and carries considerable risks for both the woman and the fetus (McCance, 2011; Knight et al, 2014). Women with pre-existing type 1 and type 2 diabetes have significant mortality and morbidity rates during pregnancy (Knight et al, 2014). Diabetes is known to carry a tenfold increase in the risk of congenital malformations such as cardiac anomalies, a fivefold increase in the risk of stillbirth and a threefold increase in the risk of neonatal death (Jensen et al, 2004; McCance, 2011). Poor glycaemic control in the early stages of organogenesis is thought to be a key aetiological contributor to these anomalies and to fetal loss (Inkster et al, 2006; Nelson-Piercy, 2010).

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