Griffiths Frances, Lowe Pam, Boardman Felicity, Ayre Catherine, Gadsby Roger
Health Sciences Research Institute, Warwick Mediical School, University of Warwick, Coventry, CV4 7Al.
Br J Gen Pract. 2008 Mar;58(548):184-90. doi: 10.3399/bjgp08X277294.
The risk of adverse pregnancy outcome for women with type 1 diabetes is reduced through tight diabetes control. Most women enter pregnancy with inadequate blood glucose control. Interview studies with women suggest the concept of 'planned' and 'unplanned' pregnancies is unhelpful.
To explore women's accounts of their journeys to becoming pregnant while living with type 1 diabetes.
Semi-structured interviews with 15 women living with pre-gestational type 1 diabetes, between 20 and 30 weeks gestation and with a normal pregnancy ultrasound scan.
Four UK specialist diabetes antenatal clinics.
Interviews explored women's journeys to becoming pregnant and the impact of health care. Analysis involved comparison of women's accounts of each pregnancy and a thematic analysis.
Women's experiences of becoming pregnant were diverse. Of the 40 pregnancies described, at least one positive step towards becoming pregnant was taken by 11 women in 23 pregnancies but not in the remaining 17 pregnancies, with variation between pregnancies. Prior to and in early pregnancy, some women described themselves as experts in their diabetes but most described seeking and/or receiving advice from their usual health professionals. Three women described pre-conception counselling and the anxiety this provoked.
For women living with type 1 diabetes each pregnancy is different. The concept of planned and unplanned pregnancy is unhelpful for designing health care. Formal preconception counselling can have unintended consequences. Those providing usual care to women are well positioned to provide advice and support to women about becoming pregnant, tailoring it to the changing needs and situation of each woman.
通过严格控制糖尿病，1型糖尿病女性不良妊娠结局的风险会降低。大多数女性在怀孕时血糖控制不佳。对女性的访谈研究表明，“计划内”和“计划外”怀孕的概念并无帮助。
探讨1型糖尿病女性讲述的怀孕历程。
对15名孕前期患有1型糖尿病、妊娠20至30周且超声检查显示妊娠正常的女性进行半结构式访谈。
英国四家糖尿病专科产前诊所。
访谈探讨女性的怀孕历程以及医疗保健的影响。分析包括比较女性对每次怀孕的描述并进行主题分析。
女性的怀孕经历各不相同。在描述的40次怀孕中，11名女性在23次怀孕中至少采取了一项积极的怀孕步骤，但在其余17次怀孕中未采取，且不同怀孕之间存在差异。在怀孕前和怀孕早期，一些女性称自己是糖尿病方面的专家，但大多数女性表示会向自己的常规医疗保健人员寻求和/或接受建议。三名女性描述了孕前咨询及其引发的焦虑。
对于患有1型糖尿病的女性来说，每次怀孕情况都不同。计划内和计划外怀孕的概念对设计医疗保健并无帮助。正式的孕前咨询可能会产生意想不到的后果。为女性提供常规护理的人员完全有能力根据每位女性不断变化的需求和情况，为其提供关于怀孕的建议和支持。
