Preconception care for diabetic women for improving maternal and infant health

Abstract

Background Infants born to mothers with pre-existing type I or type II diabetes mellitus are at greater risk of congenital anomalies, perinatal mortality and significant morbidity in the short and long term. Pregnant women with pre-existing diabetes are at greater risk of perinatal morbidity and diabetic complications. The relationship between glycaemic control and health outcomes for both mothers and infants indicates the potential for preconception care for these women to be of benefit. Objectives To assess the effects of preconception care in women with pre-existing diabetes on health outcomes for mother and baby. Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register was searched (30 April 2010) and reference lists of retrieved articles. Selection criteria Randomised, quasi-randomised and cluster-randomised trials evaluating preconception care of diabetic women. Data collection and analysis Two review authors independently conducted data extraction and quality assessment. We resolved disagreements through discussion or through a third author. Main results We included one trial (involving 53 women) in this review. The trial did not report on the prespecified outcomes of this review. Authors' conclusions Little evidence is available to recommend for or against preconception care for women with pre-existing diabetes. Further large, high-quality randomised controlled trials are needed to evaluate the effect of different protocols of preconception care for women with pre-existing diabetes.