Endocrine Abstracts

Introduction: Women with diabetes mellitus (DM) are at increased risk of adverse maternal and foetal outcomes. Preconception planning is required to minimize risks, including good understanding of contraceptive options.

Objectives: To determine in Australian women with DM beliefs regarding safety of various contraceptive methods in DM, information sources regarding contraception, recent and previous contraceptive use, knowledge of pregnancy risks, access to preconception planning and pregnancy history.

Methods: We conducted a cross-sectional 22 item structured questionnaire-based study of Australian women with DM (Type 1 or 2) aged 16–49 years attending Nepean Hospital, a tertiary referral centre. Women were recruited via mail, at scheduled appointments or hospital admission.

Results: 107 of approximately 215 (49.7%) women completed the questionnaire. 83% were aware of risks related to DM in pregnancy. However, the majority of women (74%) had not received preconception counselling. The main source of information regarding contraception was the general practitioner (70%). Most women (78%) believed combined oral contraceptive pills (COCPs) were safe in DM. 63% of women were uncertain of the safety of intra-uterine devices (IUDs) in DM and 44% were uncertain of contraceptive implant (CI) safety. The main forms of contraception ever used were condoms (87%) and COCPs (74%), with 34% using long-acting reversible contraception (LARC) of IUDs and CIs. 29% of sexually active women were not using any contraception or planning pregnancy. Amongst 110 pregnancies in 47 women there were 78 (71%) live births, 4 (4%) stillbirths, 16 (15%) miscarriages, 2 (2%) ectopic pregnancies and 10 (9%) terminations.

Conclusion: Despite knowledge of pregnancy risks, preconception counselling is lacking and pregnancy outcomes poor. There was uncertainty regarding safety of LARC, the most reliable contraceptive methods and over a quarter of women used no contraception. Better education of women with DM regarding contraception and preconception planning is needed.