Atlantic dip: closing the loop: a change in clinical practice can improve outcomes for women with pregestational diabetes
Owens, L. A. Avalos, G. Kirwan, B. Carmody, L. Dunne, F.
Owens, L. A.
Avalos, G.
Kirwan, B.
Carmody, L.
Dunne, F.
Repository DOI
Publication Date
2012-07-23
Type
Article
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Citation
Owens, L. A. Avalos, G.; Kirwan, B.; Carmody, L.; Dunne, F. (2012). Atlantic dip: closing the loop: a change in clinical practice can improve outcomes for women with pregestational diabetes. Diabetes Care 35 (8), 1669-1671
Abstract
OBJECTIVE-Prospective evaluation of pregnancy outcomes in women with pregestational diabetes over 6 years. RESEARCH DESIGN AND METHODS-The ATLANTIC Diabetes in Pregnancy group provides care for women with diabetes throughout pregnancy. In 2007, the group identified that women were poorly prepared for pregnancy and outcomes were suboptimal. A change in practice occurred, offering women specialist-led, hub-and-spoke evidence-based care. We now compare outcomes from 2005 to 2007 with those from 2008 to 2010. RESULTS-There was an increase in the numbers attending preconception care (28-52%, P = 0.01). Glycemic control before and throughout pregnancy improved. There was an overall increase in live births (74-92%, P < 0.001) and decrease in perinatal mortality rate (6.2-0.65%, P < 0.001). There was a decrease in large-for-gestational-age babies in mothers with type 1 diabetes mellitus (30-26%, P = 0.02). Elective caesarean section rates increased, while emergency section rates decreased. CONCLUSIONS-Changing the process of clinical care delivery can improve outcomes in women with pregestational diabetes
Funder
Publisher
American Diabetes Association
Publisher DOI
10.2337/dc12-0120
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland