Efficacy of preconception care in improving pregnancy outcomes for women with pre-existing diabetes mellitus

By Katie Williams, Nizara Ziaudeen, Dr Aisha Janjua, Dr Pushpa Singh

Introduction

Pregnant women with pre-existing diabetes mellitus (DM) face higher risks of maternal and fetal complications1. These risks can be reduced by delivering pre-conception care which aims to review medications, optimise glucose control and ensure high dose folic acid administration2.

Objectives 

This study evaluates the effectiveness of preconception care in improving maternal health for women with pre-existing DM.

Methods 

Setting: Preconception clinic at Queen Elizabeth Hospital Birmingham.

Participants: 99 clinic appointments (10/07/2023 - 11/11/2024), 73 patients included; 34 new referrals and 43 follow-up.

Data setting: Retrospective cohort study. Used electronic medical records.

Analysis: Analysed using excel. Subgroup analysis performed stratified by appointment type.

Conclusion

• Preconception care has a positive impact on maternal health and diabetes management.

• This is in line with NICE guideline recommendations.

• However, our study is single-centered with a small sample size and short follow-up period.

• High DNA rates were noted; further analysis required.

• Further multi-centre studies with extended follow up required.

References

1.Wahabi HA, Alzeidan RA, Bawazeer GA, Alansari LA, Esmaeil SA. Preconception care for diabetic women for improving maternal and fetal outcomes: asystematic review and meta-analysis. BMC Pregnancy and Childbirth [Internet]. 2010 Oct 14 [cited 2025 Jan 13];10(63). Available from:

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-10-63

2.Broughton C, Douek I. An overview of the management of diabetes from pre-conception, during pregnancy and in the postnatal period. ClinicalMedicine [Internet]. 2019 Sep [cited 2025 Jan 29]; 19(5). Available from:

https://pmc.ncbi.nlm.nih.gov/articles/PMC6771338/#CIT0001

3.NICE. Recommendations | Diabetes in pregnancy: Management from Preconception to the Postnatal Period | Guidance | NICE [Internet]. 2020 [cited2025 Jan 29]. Available from:

https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#preconception-planning-and-care.