Preconception counseling is recommended for all women with diabetes, starting at puberty, with a focus on achieving glycemic targets and improving maternal and fetal outcomes through educating women about pregnancy planning. We examined self-reported receipt of preconception counseling and its association with sociodemographic and clinical factors in 648 female adolescents and young adult participants with diabetes in the SEARCH for Diabetes in Youth study in 2016-2019. Crude (Chi-square and t-tests) and adjusted (logistic regression) associations were evaluated. At a mean age of 22.4 (SD 4.5) years, 31.9% were receiving diabetes care from a pediatric provider, 51.1% from an adult provider, and 17.0% from a provider who treats all ages. Only 55.4% reported ever receiving preconception counseling, which significantly differed by provider type (p>0.001). Receipt of preconception counseling was lowest among women seeing pediatric providers (38.6%) versus adult (63.1%) or all-age providers (63.6%), but differences were attenuated after adjustment for age, diabetes type, race/ethnicity, insurance type, and clinical site. With adjustment, older vs. younger age (aOR 1.20; 95% CI 1.13-1.26), type 1 vs. type 2 diabetes (aOR 1.62; 95% CI 1.02-2.56), and public vs. private health insurance (aOR 2.08; 95% CI 1.31-3.29) were associated with increased odds of reporting preconception counseling. Approximately half of female adolescents and young adults with diabetes reported not receiving preconception counseling, especially those who were younger, had type 2 diabetes or had private health insurance. Efforts to consistently deliver preconception counseling are warranted to reduce the risk for adverse pregnancy complications in this population, as well as avert substantial health issues and associated cost burdens in offspring.
A. J. Roberts: None. A. Bellatorre: None. R. Dagostino: Consultant; Self; AstraZeneca, Biogen, Daiichi Sankyo. E. T. Jensen: None. K. A. Sauder: None. J. M. Stafford: None. F. Malik: None. C. Pihoker: None. N. S. Boghossian: None. S. R. Ehrlich: None. D. J. Pettitt: None. D. Dabelea: None.
National Institute of Diabetes and Digestive and Kidney Diseases (1UC4DK108173); Centers for Disease Control and Prevention (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, U18DP006139)