Is Previous Pregnancy Affected By Diabetes Mellitus Protective against Poor Glycemic Control at the Start of Subsequent Pregnancies?Mulla BM* and Zelig CM
Department of Obstetrics and Gynecology, Naval Medical Center Portmouth, USA
- *Corresponding Author:
- Mulla BM
620 John Paul Jones Circle
E-mail: [email protected]
Received date June 09, 2012; Accepted date July 18, 2012; Published date July 24, 2012
Citation: Mulla BM, Zelig CM (2012) Is Previous Pregnancy Affected By Diabetes Mellitus Protective against Poor Glycemic Control at the Start of Subsequent Pregnancies? J Diabetes Metab 3:205. doi:10.4172/2155-6156.1000205
Copyright: © 2012 Mulla BM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aims/hypothesis: Poor glycemic control at conception, a strong risk factor for birth defects, is frequently attributed to low rates of pre-conceptual counseling. The objective of this study was to determine if counseling during a first pregnancy with diabetes improved glycemic control at conception in subsequent pregnancies.
Methods: Case controlled. 71 diabetic women previously followed during pregnancy at a single tertiary center were divided into two groups, those with diabetes at the start of a previous pregnancy, and those without. The two groups were compared for glycemic control at conception; hemoglobin A1C ≥ 7 was considered poor control. The two groups were also compared for very poor control (hemoglobin A1C ≥ 9), pre-conceptual counseling, and preconceptual folic acid use.
Results: Poor glycemic control at conception was as prevalent in the 29 previous diabetic patients as in the 42 first-time diabetic patients (51.7% vs. 57.1%, p=0.7). There was no difference in the proportion of diabetic patients with very poor control (17.2% vs. 23.8%, p=0.5), pre-conceptual counseling (6.9% vs. 4.8%, p=1.0) and folic acid use (32.1% vs. 31.0%, p=0.9).
Conclusions/interpretation: Previous pregnancy affected by diabetes did not improve glycemic control in a subsequent pregnancy. Expanding the counseling these patients receive in our institution should be considered.