Introduction

Anecdotal evidence indicates pre-pregnancy care (PPC) in women with type 2 diabetes mellitus (T2DM) is suboptimal. This project aimed to gather information on PPC in women with T2DM, including a rate, or proportion of women that have accessed PPC prior to their birth.

Method

Human research ethics approval was obtained. 92 medical files of women with T2DM birthing at the Royal Women’s Hospital (RWH) in 2021-2022 were reviewed. 55 files were eligible for inclusion. A scoping review on the clinical indicators of PPC identified folate supplementation prior to conception as the primary clinical indicator of PPC access.

Results

Of the 55 files reviewed, 66% did not state if folate supplementation occurred prior to conception, making a PPC access rate difficult to determine. Therefore, a scoping review on the clinical markers that define an ideal state of pregnancy preparation, which is indicative of PPC access, was conducted. The ideal state of pregnancy preparation was defined as an HbA1c ≤6.5% following a positive pregnancy test, general practitioner (GP) referral for pregnancy care <8/40 and self-blood glucose monitoring (SBGM) at the first hospital appointment. Documentation of these markers in the medical files was used to benchmark the ideal state to the current state of pregnancy preparation. 47% of women had an HbA1c ≤6.5%; while 44% were referred to their GP for pregnancy care <8/40; and finally 65% of women were SMBG at their first hospital appointment. In summary, 15%, or 8 out of 55 women met the criteria of an ideal state of pregnancy preparation.

 Conclusion

Using clinical markers of an ideal state of pregnancy preparation, this project was able to ascertain pregnancy preparation in women with T2DM birthing at RWH is suboptimal, which is likely to be indicative of a poor uptake of PPC.