Chief Nursing Officers of England, Northern Ireland, Scotland and Wales. Midwifery 2020: Delivering Expectations. 2010. (accessed 3 May 2016)

Dahlgren G, Whitehead MStockholm: Institute for Future Studies; 1991

Dean S, Rudan I, Althabe F, Webb Girard A, Howson C, Langer A, Lawn J, Reeve ME, Teela KC, Toledano M, Venkatraman CM, Belizan JM, Car J, Chan KY, Chatterjee S, Chitekwe S, Doherty T, Donnay F, Ezzati M, Humayun K, Jack B, Lassi ZS, Martorell R, Poortman Y, Bhutta ZA Setting research priorities for preconception care in low- and middle-income countries: aiming to reduce maternal and child mortality and morbidity. PLoS Med. 2013; 10:(9)

Knowledge about preconception care in French women with type 1 diabetes. Diabetes Metab. 2005; 31:(5)443-7

Diabetes UK. Implementing local diabetes networks. 2013. (accessed 3 May 2016)

Doetter LF, Götze R Health Care Policy for Better or for Worse? Examining NHS Reforms During Times of Economic Crisis versus Relative Stability. Social Policy and Administration. 2011; 45:(4)488-505

Doherty Y, Eaton S, Turnbull R, Oliver L, Roberts S, Ludbrook S, Lewis-Barned N Year of Care: the key drivers and theoretical basis for a new approach in diabetes care. Practical Diabetes. 2012; 29:(5)183-6f

Glinianaia SV, Tennant PW, Crowder D, Nayar R, Bell R Fifteen-year trends and predictors of preparation for pregnancy in women with pre-conception Type 1 and Type 2 diabetes: a population-based cohort study. Diabet Med. 2014; 31:(9)1104-13

Holmes VA, Spence M, McCance DR, Patterson CC, Harper R, Alderdice FA Evaluation of a DVD for women with diabetes: impact on knowledge and attitudes to preconception care. Diabet Med. 2012; 29:(7)950-6

Hughes C, Spence D, Holmes VA, McCorry NK Preconception care for women with diabetes: the midwife's role. British Journal of Midwifery. 2010; 18:(3)144-9

Hussain M, Al-Haiqi A, Zaidan AA, Zaidan BB, Kiah ML, Anuar NB, Abdulnabi M The landscape of research on smartphone medical apps: Coherent taxonomy, motivations, open challenges and recommendations. Comput Methods Programs Biomed. 2015; 122:(3)393-408

Infanti JJ, O'Dea A1, Gibson I, McGuire BE, Newell J, Glynn LG, O'Neill C, Connolly SB, Dunne FP Reasons for participation and non-participation in a diabetes prevention trial among women with prior gestational diabetes mellitus (GDM). BMC Med Res Methodol. 2014; 14

Inkster ME, Fahey TP, Donnan PT, Leese GP, Mires GJ, Murphy DJ Poor glycated haemoglobin control and adverse pregnancy outcomes in type 1 and type 2 diabetes mellitus: systematic review of observational studies. BMC Pregnancy Childbirth. 2006; 6

Irvine F Contextualising health promotion. In: Whitehead D, Irvine F (eds). London: Palgrave MacMillan; 2010

Irwin JA The future role for a diabetes specialist midwife. Best Pract Res Clin Endocrinol Metab. 2010; 24:(4)653-62

Jack BW, Atrash H, Bickmore T, Johnson K The future of preconception care: a clinical perspective. Womens Health Issues. 2008; 18:(6 Suppl)S19-25

Jensen DM, Damm P, Moelsted-Pedersen L, Ovesen P, Westergaard JG, Moeller M, Beck-Nielsen H Outcomes in type 1 diabetic pregnancies: a nationwide, population-based study. Diabetes Care. 2004; 27:(12)2819-23

Johnson K, Atrash H, Johnson A Policy and finance for preconception care opportunities for today and the future. Womens Health Issues. 2008; 18:(6 Suppl)S2-9

Kaestner R, Lee WC The effect of welfare reform on prenatal care and birth weight. Health Econ. 2005; 14:(5)497-511

King TL Prenatal care for the 21st century: outside the 20th century box. J Midwifery Womens Health. 2009; 54:(3)

Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ(eds). Oxford: National Perinatal Epidemiology Unit; 2014

Mason E, Chandra-Mouli V, Baltag V, Christiansen C, Lassi ZS, Bhutta ZA Preconception care: advancing from ‘important to do and can be done’ to ‘is being done and is making a difference’. Reprod Health. 2014; 11

Mathai M Working with communities, governments and academic institutions to make pregnancy safer. Best Pract Res Clin Obstet Gynaecol. 2008; 22:(3)465-76

McCance DR Pregnancy and diabetes. Best Pract Res Clin Endocrinol Metab. 2011; 25:(6)945-58

McCorry NK, Hughes C, Spence D, Holmes VA, Harper R Pregnancy planning and diabetes: a qualitative exploration of women's attitudes toward preconception care. J Midwifery Womens Health. 2012; 57:(4)396-402

Murphy HR, Temple RC, Ball VE, Roland JM, Steel S, E-Huma R, Simmons D, Royce LR, Skinner TC Personal experiences of women with diabetes who do not attend pre-pregnancy care. Diabet Med. 2010; 27:(1)92-100

National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. 2015. (accessed 3 May 2016)

Nelson-Piercy C Recurrence of hyperemesis across generations. BMJ. 2010; 340

O'Higgins S, McGuire BE, Mustafa E, Dunne F Barriers and facilitators to attending pre-pregnancy care services: the ATLANTIC-DIP experience. Diabet Med. 2014; 31:(3)366-74

Posner SF, Johnson K, Parker C, Atrash H, Biermann J The national summit on preconception care: a summary of concepts and recommendations. Matern Child Health J. 2006; 10:(5 Suppl)S197-205

Porter ME, Teisberg EOBoston: Harvard Business School Press; 2006

Robinson F, Jones C Women's engagement with mobile device applications in pregnancy and childbirth. Pract Midwife. 2014; 17:(1)23-5

London: RCOG; 2008

Schwarz EB, Sobota M, Charron-Prochownik D Perceived access to contraception among adolescents with diabetes: barriers to preventing pregnancy complications. Diabetes Educ. 2010; 36:(3)489-94

Shannon GD, Alberg C, Nacul L, Pashayan N Preconception healthcare delivery at a population level: construction of public health models of preconception care. Matern Child Health J. 2014; 18:(6)1512-31

Smith LK, Draper ES, Manktelow BN, Dorling JS, Field DJ Socioeconomic inequalities in very preterm birth rates. Arch Dis Child Fetal Neonatal Ed. 2007; 92:(1)F11-4

Smith A, Shakespeare J, Dixon ALondon: The King's Fund; 2010

Spence M, Alderdice FA, Harper R, McCance DR, Holmes VA An exploration of knowledge and attitudes related to pre-pregnancy care in women with diabetes. Diabet Med. 2010; 27:(12)1385-91

Spence M, Harper R, McCance D, Alderice FA, McKinley MC, Hughes C, Holmes VA The systematic development of an innovative DVD to raise awareness of preconception care. European Diabetes Nursing. 2013; 10:(1)7-12b

Temple R Preconception care for women with diabetes: is it effective and who should provide it?. Best Pract Res Clin Obstet Gynaecol. 2011; 25:(1)3-14

Tripp N, Hainey K, Liu A, Poulton A, Peek M, Kim J, Nanan R An emerging model of maternity care: smartphone, midwife, doctor?. Women Birth. 2014; 27:(1)64-7

van Heesch PN, de Weerd S, Kotey S, Steegers EA Dutch community midwives' views on preconception care. Midwifery. 2006; 22:(2)120-4

World Health Organization. 1986. (accessed 5 May 2016)

Geneva: WHO; 2013

Xaverius PK, Salas J, Kiel D Differences in pregnancy planning between women aged 18-44, with and without diabetes: behavioral risk factor surveillance system analysis. Diabetes Res Clin Pract. 2013; 99:(1)63-8

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

02 June 2016
10 min read
Volume 24 · Issue 6


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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