Diabetes in pregnancy: are we providing the best care ... - HQIP

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Appendix E Association between postnatal care factors of fetal and neonatal deaths (excluding major fetal congenital anomaly) from 20 weeks gestation in babies of women with type 1 and type 2 diabetes Postnatal care factor Cases n/N (%) Controls n/N (%) Crude OR [95% CI] Adjusted OR a No postnatal contraceptive advice 24/60 (40) 26/163 (16) 3.5 [1.8, 7.0] 4.1 [2.0, 8.2] No written plan for post-delivery diabetes management 12/84 (14) 25/188 (13) 1.1 [0.5, 2.3] 1.2 [0.5, 2.6] Assessment of suboptimal postnatal diabetes care 61/87 (70) 106/211 (50) 2.3 [1.4, 4.0] 2.5 [1.4, 4.3] a Adjusted for maternal age and deprivation. 134
Appendix F - CEMACH advisory groups & contributors Appendix F - CEMACH advisory groups & contributors Diabetes Professional Advisory Group Stephen Walkinshaw Chair, Consultant Obstetrician, Liverpool Women’s Hospital Jean Chapple Consultant in Perinatal Epidemiology, Westminster Primary Care Trust Richard Congdon CEMACH Chief Executive Simon Court Consultant Paediatrician, Newcastle General Hospital (Diabetes UK) Pat Doyle Epidemiologist, London School of Hygiene & Tropical Medicine Kate Fleming CEMACH Senior Data Analyst (until November 2006) Shona Golightly CEMACH Director of Development and Research Olwen Harrison Diabetes Nurse Specialist, North Hampshire Hospital Jane Hawdon Consultant Neonatologist, University College London Hospitals Gillian Hawthorne Consultant Diabetes Physician, Newcastle General Hospital Anita Holdcroft Consultant Anaesthetist, Chelsea and Westminster Hospital, London Julie Maddocks CEMACH Regional Manager (North West & West Midlands) Mary Macintosh CEMACH Medical Director (Until May 2006) Rona McCandlish Professor of Midwifery, National Perinatal Epidemiology Unit Jo Modder CEMACH Clinical Director (Obstetrics) Alison Miller CEMACH Programme Director and Midwifery Lead Mary Pierce Royal College of General Practitioners representative Bob Young Consultant Diabetes Physician, Hope Hospital, Salford CEMACH Central Offi ce Staff Dominique Acolet Clinical Director (Perinatal Epidemiology) Naufil Alam Data Analyst Jessica Berenston-Shaw National Clinical Projects Advisor John Bolton Accountant Nicola Cogdell Administrative Assistant Kirshnee Chetty Administrative Assistant (until February 2007) Richard Congdon Chief Executive Shona Golightly Director of Research and Development Rosie Houston Assistant Projects Manager Mary Humphreys Offi ce Administrator Alison Miller Programme Director and Midwifery Lead Jo Modder Clinical Director (Obstetrics) Iman Mortagy Data Analyst Dharmishta Parmar Data Manager Gale Pearson Clinical Director (Child Health) Maureen Wilson Committee Administrator 135
Page 1 and 2:
Confidential Enquiry into Maternal
Page 3 and 4:
Contents Acknowledgements .........
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• Members of the CEMACH Diabetes
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Erb’s palsy Injury to the nerve r
Page 9 and 10:
Neonatal unit A unit which provides
Page 11 and 12:
Foreword This third and fi nal repo
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1. Introduction This is the fi nal
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2. Key fi ndings of the CEMACH Diab
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Suboptimal fetal surveillance of ba
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3. Summary of recommendations This
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2. Patient pathways of care includi
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the pregnancies meeting this defi n
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in order to remove any identifi abl
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When deriving odds ratios for any p
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Associations are reported in Chapte
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Table 5.1 Characteristics of women
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Table 5.4 Characteristics of women
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was no information available to pan
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6. Factors associated with poor pre
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Table 6.2 Association of clinical c
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Table 6.5 Association of specifi c
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Table 6.8 Association of postnatal
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folic acid before pregnancy (19% of
Page 47 and 48:
Table 7.2 Panel comments on social
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7.5 Conclusions One of the key fi n
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11.Dex S, Heather J (eds). Millenni
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8. Clinical care issues: preconcept
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chance of induction of labour was r
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8.6.1 Enquiry fi ndings Just over h
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Some quotes from the panel discussi
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Apart from the explanation of pregn
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was associated with poor pregnancy
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of women after the fi rst trimester
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9.5.1 Panel comments on suboptimal
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During labour and delivery, the maj
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Just 52% of 383 women (38% of 164 c
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• ‘No serial growth scans perfo
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The panel enquiries, which are in e
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10.3.1 Enquiry fi ndings Seventy fi
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10.6 Communication Effective commun
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Some quotes from the panel discussi
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working between primary and seconda
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we therefore selected 7.2% of pregn
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11.4 Preconception behaviour The CE
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enquiry related to a 12 month prior
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Table 11.10 Differences in postnata
Page 93 and 94:
Type 1 and type 2 diabetes have tra
Page 95 and 96: Panels were chaired by the panel ch
Page 97 and 98: In 57% (24/42) of cases, a junior d
Page 99 and 100: Infant formula given as fi rst feed
Page 101 and 102: 2.1 hours in babies remaining with
Page 103 and 104: 12.7.1 Panel comments on suboptimal
Page 105 and 106: The concerns described here probabl
Page 107 and 108: External commentary Patricia Hamilt
Page 109 and 110: informed and motivated to manage th
Page 112 and 113: 100 Appendix A: Pre-pregnancy care
Page 114 and 115: 102 Appendix B: Diabetes enquiry pr
Page 132 and 133: Appendix C Association between demo
Page 134 and 135: Appendix C Association of preconcep
Page 136 and 137: Appendix C Association of postnatal
Page 138 and 139: Appendix D Association of social an
Page 140 and 141: Appendix D Association of diabetes
Page 142 and 143: Appendix E Association between demo
Page 144 and 145: Appendix E Association between prec
Page 148 and 149: Appendix F - CEMACH advisory groups
Page 150: Appendix F - CEMACH advisory groups
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