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

Table 7.2
Panel comments on social and lifestyle issues underlying suboptimal glycaemic control during pregnancy in women
with pre-existing diabetes (table contains information following categorisation of free text)
Women assessed to have suboptimal
glycaemic control in the 1st trimester
Good pregnancy
outcome
(N=118)
No. of
comments
% of
women
Poor pregnancy
outcome
(N=171)
No. of
comments
% of
women
Women assessed to have suboptimal
glycaemic control after the 1st trimester
Good pregnancy
outcome
(N=76)
No. of
comments
% of
women
Poor pregnancy
outcome
(N=146)
No. of
comments
% of
women
Total
comments* 57 - 97 - 27 - 67 -
Non adherence
to medical 19 16 36 21 11 14 26 18
advice
Medical,
lifestyle or 8 7 9 5 4 5 11 8
social factors
Duration and
severity of 6 5 8 5 4 5 10 7
diabetes
Woman did not
attend planned 10 8 21 12 5 7 14 10
appointments
Actively chose
not to follow 1 1 3 2 3 4 6 4
medical advice
Late booker 6 5 14 8 0 0 0 0
Unplanned
pregnancy 7 6 6 4 0 0 0 0
* There were 178 comments made about clinical care issues; these comments are not included in this table but are included in
table 9.1 (Chapter 9).
7.4 Women’s approach to managing their diabetes
Women with diabetes may have an increased burden on their work and personal lives both before and
during pregnancy, due to the additional issues which arise at this time. This can sometimes lead to a
suboptimal approach to managing their diabetes.
7.4.1 Panel assessment of women’s approach to managing their diabetes
Enquiry panels assessed that 51% of 434 women had a suboptimal approach to managing their diabetes
before pregnancy (62% of 216 cases and 40% of 218 controls) and 40% of 434 women had a suboptimal
approach to managing their diabetes during pregnancy (55% of 216 cases and 26% of 218 controls).
A suboptimal approach of the woman to managing her diabetes either before or during pregnancy was
associated with poor pregnancy outcome (OR 4.9, 95% CI 2.7 - 8.8 and OR 3.9 , 95% CI 2.5 - 6.1
respectively, adjusted for maternal age and deprivation, see Chapter 6).
35