Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Reprod Health. 2023 Oct 12;20(1):152. doi: 10.1186/s12978-023-01694-w.
Pre-existing diabetes mellitus (DM) is a challenging pregnancy complication as poor glycemic control is associated with adverse maternal and fetal outcomes. In this study, we aimed to investigate DM-related knowledge, attitudes, preconception care practices, and contraceptive prevalence in women with DM.
This descriptive cross-sectional survey was conducted among reproductive-aged Thai women receiving DM treatment at King Chulalongkorn Memorial Hospital between August 1, 2021, and June 30, 2022. Patients with DM who were not pregnant or trying to conceive and could be contacted via the phone were included and a validated self-administered questionnaire was distributed electronically.
A total of 238 participants were included in the final analysis, yielding 69.4% response rates. The mean (standard deviation) score for knowledge of pregnancy planning and pregnancy-related risks was 6.8 (3.5) out of 15. Only about half of the participants had discussed pregnancy planning with their physicians. Multivariable analysis showed that younger age at DM diagnosis, non-Buddhism, married, higher education, and medical personnel were significantly associated with higher knowledge scores. Women aged > 45 years and those with higher practice scores had significantly higher adjusted odds of using highly effective contraception; the most common methods included male condoms and combined oral contraceptive pills. There was an unmet need for contraception in 9.5% of women with DM.
Although highly effective contraception is safe for patients with DM, only about half of our participants used tier one or two contraceptives or had received consultation regarding preconception planning. There was a notable gap in care coordination among specialists; integrating reproductive healthcare into DM therapy would improve access to preconception care.
患有糖尿病（DM）是一种具有挑战性的妊娠并发症，因为血糖控制不佳与母婴不良结局有关。在这项研究中，我们旨在调查患有 DM 的女性的 DM 相关知识、态度、孕前保健实践和避孕措施的流行情况。
这是一项描述性的横断面调查，于 2021 年 8 月 1 日至 2022 年 6 月 30 日期间在泰国朱拉隆功国王纪念医院接受 DM 治疗的育龄期泰国女性中进行。纳入未怀孕或正在尝试怀孕且可通过电话联系的 DM 患者，并通过电子方式分发经过验证的自我管理问卷。
共有 238 名参与者被纳入最终分析，应答率为 69.4%。对妊娠计划和妊娠相关风险的知识的平均（标准差）评分为 15 分中的 6.8（3.5）分。只有大约一半的参与者与医生讨论过妊娠计划。多变量分析显示，DM 诊断年龄较小、非佛教徒、已婚、接受过更高教育和医务人员与更高的知识评分显著相关。年龄＞45 岁的女性和实践评分较高的女性使用高效避孕措施的调整后优势比显著较高；最常见的方法包括男用避孕套和复方口服避孕药。有 9.5%的 DM 女性存在避孕需求未得到满足。
虽然高效避孕措施对 DM 患者是安全的，但我们的参与者中只有大约一半使用了一级或二级避孕措施，或接受过关于孕前计划的咨询。专家之间的护理协调存在明显差距；将生殖保健纳入 DM 治疗将改善获得孕前保健的机会。
