To assess pregnancy‐related care and outcomes for women with pre‐gestational, Type 1 diabetes.
The study was a prospective, population‐based, clinical audit in Scotland. A total of 273 and 179 pregnancies in two 12‐month audit periods (during 1998/99 and 2003/04 respectively) were examined.
In both years, antenatal care for women with diabetes was well organised by dedicated multi‐professional teams. Provision of formal pre‐pregnancy clinics increased (1998, four of 22 maternity units; 2003, six of 20 units). Pregnancies documented as “planned” (1998/99, 116/273, or 42.5 per cent; 2003/04, 105/179, or 58.7 per cent; p=0.001) and periconceptual folic acid supplementation, 5 mg daily (1998/99, 40/273, or 14.7 per cent; 2003/04, 71/179, or 39.7 per cent; ppz scores: 1.57 in 1998/99 and 1.64 in 2003/04; standard deviations above a reference population mean) and perinatal mortality appeared higher than for the Scottish population (27.9/1,000 in 1998/99 and 24.8/1,000 in 2003/04). There was a (non‐significant) fall in congenital anomaly rate (1998/99: 13/215 births, or 60/1,000; 2003/04, 6/161 births, or 24.8/1,000).
Re‐audit after a five‐year interval showed that periconceptual care and pregnancy planning for Scottish women with Type 1 diabetes has improved. Although pregnancy outcomes remain poorer than for the general Scottish population, the apparent reduction in congenital anomalies is encouraging.