DIABETES AND PREGNANCY - FACTORS ASSOCIATED WITH SEEKING PRE-CONCEPTION CARE
DIABETES AND PREGNANCY - FACTORS ASSOCIATED WITH SEEKING PRE-CONCEPTION CARE
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DOI：
10.2337/diacare.18.2.157
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发表时间：
1995-02-01
期刊：
影响因子：
16.2
通讯作者：
LORENZ, RP
中科院分区：
文献类型：
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作者：
JANZ, NK;HERMAN, WH;LORENZ, RP
目的：定义社会人口学特征、医学因素、知识、态度和与健康相关的行为，以区分已确诊的糖尿病妇女在孕前寻求护理和仅在怀孕后寻求护理。研究设计和方法：一项多中心病例对照研究，研究对象为首次孕前就诊（n = 57）或未接受孕前护理的首次产前就诊（n = 97）的确诊糖尿病妇女。结果：怀孕前的受试者更有可能结婚（93比51%）、与伴侣同居（93比60%）和就业（78比41%）；拥有更高的教育水平（73%高中以上对41%）和收入（86%至20,000美元对60%）；胰岛素依赖型糖尿病（IDDM）患者（93比81%）。患有IDDM的孕前受试者更有可能与他们的卫生保健提供者讨论孕前护理（98比51%），并被鼓励接受孕前护理（77比43%）。在产前组中，只有24%的怀孕是有计划的。孕前患者对糖尿病有更多的了解，认为孕前护理有更大的好处，并得到更多的工具支持。结论：只有约三分之一的确诊糖尿病妇女接受孕前护理。干预措施必须解决预防意外怀孕的问题。提供者必须把每一次与糖尿病妇女的访问视为孕前访问。必须明确讨论避孕问题，并计划怀孕。在咨询中，应强调孕前护理的好处，并应征求家人和朋友的支持。
OBJECTIVE- To define sociodemographic characteristics, medical factors, knowledge, attitudes, and health-related behaviors that distinguish women with established diabetes who seek pre-conception care from those who seek care only after conception.RESEARCH DESIGN AND METHODS- A multicenter, case-control study of women with established diabetes making their first pre-conception visit (n = 57) or first prenatal visit without having received pre-conception care (n = 97).RESULTS- Pre-conception subjects were significantly more likely to be married (93 vs. 51%), living with their partners (93 vs. 60%), and employed (78 vs. 41%); to have higher levels of education (73% beyond high school vs. 41%) and income (86% > $20,000 vs. 60%); and to have insulin-dependent diabetes mellitus (IDDM) (93 vs. 81%). Pre-conception subjects with IDDM were more likely to have discussed preconception care with their health care providers (98 vs. 51%) and to have been encouraged to get it (77 vs. 43%). In the prenatal group, only 24% of pregnancies were planned. Pre-conception patients were more knowledgeable about diabetes, perceived greater benefits of pre-conception care, and received more instrumental support.CONCLUSIONS- Only about one-third of women with established diabetes receive pre-conception care. Interventions must address prevention of unintended pregnancy. Providers must regard every visit with a diabetic woman as a pre-conception visit. Contraception must be explicitly discussed, and pregnancies should be planned. In counseling, the benefits of pre-conception care should be stressed and the support oi families and friends should be elicited.