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Family planning vigilance increases preconception counseling in type 1 diabetes
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Women with type 1 diabetes who are vigilant about family planning receive preconception counseling earlier and have better diabetes outcomes than women who are not vigilant, study data show.
“The components of [family planning vigilance] behaviors include contraceptive vigilance, receiving [preconception counseling], and initiating discussions about [preconception counseling] topics with health care professionals,” the researchers wrote. “All components are necessary to prevent an unplanned pregnancy and to plan a pregnancy that is safe and wanted with tight metabolic control.”
Susan M. Sereika, PhD, professor at the School of Nursing at the University of Pittsburgh, and colleagues evaluated women (mean age, 23.7 years) with type 1 diabetes who participated in a preconception counseling intervention trial as adolescents (intervention, n = 30; usual care, n = 22) and matched comparison women who did not participate in an intervention (n = 50). Family planning behaviors, diabetes self-care management, and clinical and reproductive health outcome information were gathered from online questionnaires completed by participants.
Most of the women (78.4%) were sexually active, and 22% reported receiving preconception planning and preconception care, all of whom were sexually active (P = .006), according to the researchers. Compared with participants who were never sexually active, participants who were sexually active were more likely to initiate discussions with health care professionals (P = .01). Among sexually active participants, 98.7% reported having used some form of contraception, but 50% were aware of the need to use contraception every time they had sexual intercourse if they were not planning a pregnancy.
Overall, 77 participants who were sexually active could be classified by their vigilance status: nonvigilant (n = 37), contraceptive vigilant (n = 29) and family planning vigilant (n = 11). More effective family planning methods were reported by the contraceptive vigilant and family planning vigilant groups compared with the nonvigilant group (P = .025). Participants in the family planning vigilant group were more aware of preconception counseling (P = .046), had received preconception counseling (P < .001) and were younger when they first received preconception counseling (P < .001) compared with the other two groups. The family planning vigilant group and contraception vigilant group experienced lower rates of diabetic ketoacidosis compared with the nonvigilant group (P = .04).
“For women with diabetes, vigilance must include pregnancy planning behavior (receiving [preconception counseling] and preconception care) and initiation of discussion with health care professionals, along with the use of effective family planning behavior (frequency and level of contraceptive effectiveness),” the researchers wrote. “Further analyses are warranted to determine the association between [family planning vigilance] and pregnancy outcomes and the most effective delivery of [preconception counseling] to enhance [family planning vigilance] in women with diabetes.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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