The Awareness of Preconception Counseling in Childbearing Age Women with Type 1 Diabetes Mellitus in China

Objectives: To assess the awareness of preconception counseling in childbearing age women with T1DM (type 1 diabetes mellitus) in China.

Methods: Women with T1DM in childbearing age were enrolled from 11 hospitals in Beijing, Jinan, Nanjing, Shanghai, Chengdu, Changsha and Guangzhou from May 2015 to August 2017. Demographic data, clinical characteristics and information on preconception counseling were collected. Redcap was used to establish the database and SPSS 20.0 was adopted to analyze data.

Results: A total of 178 T1DM women with age 30.43±4.34 years and duration of T1DM 20.52±7.62 years were enrolled. Patients were pregnant (≤13 weeks, n=89; 13-28 weeks, n=30; ≥28 weeks, n=12) or planning pregnancy (n=47). There were 85.9% of patients realizing pregnancy was permitted when HbA1c< 7.0% while 2.2% worrying T1DM women cannot be pregnant due to genetic susceptibility or potential injury. Most patients had the awareness to perform thyroid function test (92.0%), blood/urine ketone test (94.2%), diabetic retinopathy (90.8%) and nephropathy screening (95.4%) before pregnancy. Patients considered it was necessary to tighten glycemic control(100.0%) and postprandial glucose monitoring should be included (90.1%). Most patients(93.6%) admitted intake of multivitamin and folic acid was essential and 96.0% of them knew weight control and exercise for at least 30 mins per day,while only 78.5% thought preparing for a delivery in advance of the third trimester was necessary. Among 131 pregnant women, 65.6% received preconception counseling; patients with preconception counseling had better glycemic control before pregnancy compared with those without counseling (HbA1c 6.73±0.93% vs. 7.55±1.38%, P=0.028; severe hypoglycemic 25.6% vs. 61.9%, P<0.001).

Conclusion: The awareness of preconception counseling had been improved but was still not sufficient. Effective preconception counseling was associated with better glycemic control before pregnancy in pregnant women with T1DM.