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dc.contributor.authorEgan, Aoife M.
dc.contributor.authorDanyliv, Andriy
dc.contributor.authorCarmody, Louise
dc.contributor.authorKirwan, Breda
dc.contributor.authorDunne, Fidelma P.
dc.date.accessioned2018-09-20T16:06:59Z
dc.date.available2018-09-20T16:06:59Z
dc.date.issued2016-04-01
dc.identifier.citationEgan, Aoife M. Danyliv, Andriy; Carmody, Louise; Kirwan, Breda; Dunne, Fidelma P. (2016). A prepregnancy care program for women with diabetes: effective and cost saving. The Journal of Clinical Endocrinology & Metabolism 101 (4), 1807-1815
dc.identifier.issn0021-972X,1945-7197
dc.identifier.urihttp://hdl.handle.net/10379/11318
dc.description.abstractContext: Only a minority of women with diabetes attend prepregnancy care service and the economic effects of providing this service are unclear. Objective: The objective of the study was to design, put into practice, and evaluate a regional prepregnancy care program for women with types 1 and 2 diabetes. Design: This was a prospective cohort and cost-analysis study. Setting: The study was conducted at antenatal centers along the Irish Atlantic Seaboard. Participants: Four hundred fourteen women with type 1 or 2 diabetes participated in the study. Intervention: The intervention for the study was a newly developed prepregnancy care program. Main Outcome Measures: The program was assessed for its effect on the risk of adverse pregnancy outcomes. The difference between program delivery cost and the excess cost of treating adverse outcomes in nonattendees was evaluated. Results: In total, 149 (36%) attended: this increased from 19% to 50% after increased recruitment measures in 2010. Attendees were more likely to take preconception folic acid (97.3% vs 57.7%, P < .001) and less likely to smoke (8.7% vs 16.6%, P = .03) or take potentially teratogenic medications at conception (0.7 vs 6.0, P = .008). Attendees had lower glycated hemoglobin levels throughout pregnancy (first trimester glycated hemoglobin 6.8% vs 7.7%, P < .001; third trimester glycated hemoglobin6.1% vs 6.5%, P = .001), and their off spring had lower rates of serious adverse outcomes (2.4% vs 10.5%, P = .007). The adjusted difference in complication costs between those who received prepregnancy care vs usual antenatal care only is (sic)2578.00. The average cost of prepregnancy care delivery is (sic)449.00 per pregnancy. Conclusions: This regional prepregnancy care program is clinically effective. The cost of program delivery is less than the excess cost of managing adverse pregnancy outcomes.
dc.publisherThe Endocrine Society
dc.relation.ispartofThe Journal of Clinical Endocrinology & Metabolism
dc.subjectgestational weight-gain
dc.subjectpregnancy outcomes
dc.subjectglycemic control
dc.subjecttype-1
dc.subjectexperience
dc.subjectmellitus
dc.subjectcomplications
dc.subjectrisk
dc.titleA prepregnancy care program for women with diabetes: effective and cost saving
dc.typeArticle
dc.identifier.doi10.1210/jc.2015-4046
dc.local.publishedsourcehttps://academic.oup.com/jcem/article-pdf/101/4/1807/10497042/jcem1807.pdf
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