Why don't women with diabetes plan their pregnancies?
Why don't women with diabetes plan their pregnancies?
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DOI：
10.2337/diacare.21.6.889
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发表时间：
1998-06-01
期刊：
影响因子：
16.2
通讯作者：
Connell, FA
中科院分区：
文献类型：
--
作者：
Holing, EV;Brown, ZA;Connell, FA
目的-为了确定为什么妇女糖尿病患者一般不计划他们的preg tancies，因此进入他们的怀孕与血糖控制不佳，大大增加了出生缺陷的风险在their infants.RESEARCH设计和方法-一个以人口为基础的样本，85名妇女诊断为糖尿病的指数怀孕前招募6个月内产后15家医院在华盛顿。计划和计划外怀孕的妇女进行了比较，使用定性和定量分析的个人访谈，自我管理的问卷调查，和医疗记录review.RESULTS -虽然大多数妇女（79%）知道他们应该优化自己的血糖水平在怀孕前，不到一半（41%）的怀孕计划。有计划怀孕的妇女收入明显更高，受教育程度更高;更有可能拥有私人医疗保险，在怀孕前看内分泌学家，婚姻幸福，是白人;吸烟的可能性更小。大多数意外怀孕不是避孕失败，而是有意识或无意识的意图。计划怀孕的妇女一般描述了与其医疗保健提供者的持续和积极的关系。妇女谁觉得他们的医生劝阻怀孕更有可能有一个计划外的怀孕比妇女谁已经放心，他们可以有一个健康的baby.CONCLUSIONS -许多女性糖尿病患者仍然认为有关怀孕的负面信息，并成为怀孕没有最佳的计划。我们相信，有很多机会可以增加计划怀孕的糖尿病妇女的比例，特别是在孕前信息，妇女得到的支持以及他们在医疗保健系统中经历的关系质量方面。至关重要的是，夫妇们要放心，通过孕前血糖控制，几乎所有糖尿病患者都可以生下健康的婴儿。
OBJECTIVE - To determine why women with diabetes generally do not plan their preg nancies, consequently entering their pregnancies with poor blood glucose control and greatly increasing the risk of birth defects in their infants.RESEARCH DESIGN AND METHODS - A population-based sample of 85 women with diabetes diagnosed before the index pregnancy were recruited within 6 months postpartum from 15 hospitals in the state of Washington. Women with planned and unplanned pregnancies were compared using qualitative and quantitative analysis of personal interviews, self-administered questionnaires, and medical record review.RESULTS - Although most women (79%) knew they should optimize their blood glucose levels before conception, fewer than half (41%) of their pregnancies were planned. Women with planned pregnancies had significantly higher income and more education; were more likely to have private health insurance, to see an endocrinologist before pregnancy to be happily married, and to be Caucasian; and were less likely to use tobacco. Most unplanned pregnancies were not contraceptive failures, but may have been consciously or subconsciously intended. Women with planned pregnancies generally described an ongoing and positive relationship with their health care providers. Women who felt that their doctors discouraged pregnancy were more likely to have an unplanned pregnancy than were women who had been reassured they could have a healthy baby.CONCLUSIONS - Many women with diabetes still perceive negative messages about pregnancies and become pregnant without optimal planning. We believe there are many opportunities for increasing the proportion of women with diabetes who plan their pregnancies, particularly in the areas of prepregnancy information, support that women are given, and the quality of the relationships they experience within the health care system. It is crucial that couples be reassured that with pre-conception glucose control, almost all women with diabetes can have healthy babies.