Missed opportunities for appropriate postpartum care in women with pregestational diabetes

Shlomit Riskin-Mashiah, Ronit Almog

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Our aim was to evaluate postpartum glycemic control in women with pregestational diabetes and to assess contributing factors. Methods: Retrospective data collection from an electronic database on a cohort of Israeli women at Clalit Healthcare Services with pregestational diabetes who gave birth in 2008-2011, including data on HbA1C, prescription fillings, and socio-demographics. HbA1C level was assessed during a 2 year time-period, from periconception until one-year postpartum. Results: There were 180 deliveries to 166 women. Compared with the periconception period, the HbA1C level improved significantly during the last 6 months of pregnancy (6.7% versus 6.0%, p < 0.05). However, there was rapid continuous deterioration in glycemic control in the postpartum period with median HbA1C = 6.9% in the first 6 months postpartum and 7.2% in the late postpartum period (p < 0.05). One-year postpartum 107 women (59.4%) had suboptimal care (defined as HbA1C > 7.0% or no test). In the multiple logistic regression analysis, the only significant predictor of 1-year postpartum suboptimal care was suboptimal periconception care, OR = 6.1 (95% CI 3.15-11.84, p = 0.001). Conclusions: Postpartum glycemic control deteriorated rapidly despite excellent control in most women in the last 6 month of pregnancy. More intensive and targeted intervention is needed in order to optimize postpartum care of diabetic patients.

Original languageEnglish
Pages (from-to)1715-1719
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number11
DOIs
StatePublished - 2 Jun 2016

Bibliographical note

Publisher Copyright:
© 2015 Taylor & Francis.

Keywords

  • Glycemic control
  • postpartum HbA
  • quality of care
  • type 1 or 2 diabetes

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Fingerprint

Dive into the research topics of 'Missed opportunities for appropriate postpartum care in women with pregestational diabetes'. Together they form a unique fingerprint.

Cite this