THE IMPACT OF PRECONCEPTION COUNSELING ON PREGNANCY OUTCOMES - THE EXPERIENCE OF THE MAINE DIABETES IN PREGNANCY PROGRAM
THE IMPACT OF PRECONCEPTION COUNSELING ON PREGNANCY OUTCOMES - THE EXPERIENCE OF THE MAINE DIABETES IN PREGNANCY PROGRAM
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DOI：
10.2337/diacare.16.2.450
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发表时间：
1993-02-01
期刊：
影响因子：
16.2
通讯作者：
SPEAR, NH
中科院分区：
文献类型：
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作者：
WILLHOITE, MB;BENNERT, HW;SPEAR, NH
目的：确定是否可以建立一个非集中式的、全州范围的项目，以教育医疗保健提供者和妊娠糖尿病患者了解预防妊娠合并糖尿病不良后果的可用策略。对参与该计划的妇女的特征及其怀孕结果进行评估。研究设计和方法：建立了一个照顾糖尿病孕妇的区域提供者网络。对提供者和患有糖尿病的妇女都进行了关于孕前咨询重要性的继续教育。结果：缅因州的卫生保健提供者合作制定并采用了三个患者护理指南，解决了孕前咨询、产前护理和已确诊糖尿病妇女的避孕问题。在报告1987年1月1日至1990年12月31日期间估计分娩日期的160名妊娠期糖尿病妇女中，共确定了185例妊娠。在所有怀孕中，62例（34%）发生在接受孕前咨询的妇女中，其中1例主要先天性缺陷（1.6%）和4例胎儿或新生儿死亡（6.4%）。在123例（66%）未接受孕前咨询的妇女怀孕中，8例（6.5%）婴儿出生时患有先天性异常，26例（21.1%）胎儿或新生儿死亡。结论：一个促进孕前咨询的项目可以在全州范围内通过使用不同的医疗保健提供者来实施该项目。参与这样的项目似乎与妊娠期糖尿病妇女妊娠结局的改善有关。
OBJECTIVE - To determine if a noncentralized, statewide program could be established to educate health-care providers and women with pregestational diabetes on available strategies to prevent adverse outcomes in pregnancies complicated by diabetes. Characteristics of women who participated in the program and the outcomes of their pregnancies are evaluated.RESEARCH DESIGN AND METHODS - A network of regional providers caring for pregnant women with diabetes was developed. Continuing education sessions were delivered to both providers and women with existing diabetes on the importance of preconception counseling.RESULTS - Maine health care providers collaborated on the development and adoption of three patient care guidelines that address preconception counseling prenatal care, and contraception for women with established diabetes. A total of 185 pregnancies among 160 women with pregestational diabetes reported estimated delivery dates between 1 January 1987 and 31 December 1990 were identified. Of the total pregnancies, 62 (34%) occurred in women who received preconception counseling among these 62 pregnancies were one major congenital defect (1.6%) and four fetal or neonatal deaths (6.4%). Among the 123 (66%) pregnancies occurring in women that had not received preconception counseling, 8 (6.5%) infants were born with congenital abnormalities, and 26 (21.1%) fetal or neonatal deaths were documented.CONCLUSIONS - A program promoting preconception counseling can be implemented on a statewide basis by using various health-care providers to deliver the program. Participation in such a program appears to be related to improved pregnancy outcomes among women with pregestational diabetes.