Introduction
Individuals who have diabetes or hypertension established before pregnancy are at
increased risk for maternal and infant health complications. Guidelines recommend
that providers deliver prepregnancy counseling, but little is known about the receipt
of those services among patients with chronic conditions.
Methods
Data from the 2016–2018 Pregnancy Risk Assessment Monitoring System, a population-based
survey among women with recent live births, were used. Self-reported receipt of prepregnancy
counseling on folic acid supplementation, pregnancy desire, contraceptive use, and
improving health before pregnancy was examined overall and by diabetes and hypertension
status. Multivariable logistic regression examined the association between diabetes
and hypertension status and the 4 prepregnancy counseling outcomes. Analyses were
conducted in 2020.
Results
Overall, 2.1% of women reported having both diabetes and hypertension, 1.3% reported
having diabetes alone, and 3.1% reported having hypertension alone. Less than half
of the sample reported receiving each prepregnancy counseling outcome. In adjusted
models, women with hypertension alone were more likely to report each counseling outcome
than women without diabetes or hypertension. Women with diabetes alone were only more
likely to report receiving counseling about improving health, and women with both
conditions were not more likely to report the receipt of any counseling outcome under
study.
Conclusions
Women with prepregnancy diabetes, hypertension, or both reported low levels of the
recommended prepregnancy counseling, suggesting an evidence–practice gap that should
be addressed to optimize maternal and infant health outcomes. There is a need for
evidence-based and patient-centered models of prepregnancy counseling for those with
diabetes and hypertension.
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Article Info
Publication History
Published online: June 25, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
