Abstract
Is Self-Reported Insulin Adherence Associated With Maternal and Neonatal Outcomes? [23I]
Obstetrics and gynecology (New York. 1953), Vol.131(Supplement), pp.103-104S
05/2018
DOI: 10.1097/01.AOG.0000533449.15396.ed
Abstract
INTRODUCTION:
Diabetes in pregnancy carries significant maternal and fetal risks. Medication adherence is critical to optimize glucose control and neonatal outcomes. Outside of pregnancy, high self-reported adherence is associated with lower glycosylated hemoglobin (HbA1c) values. We hypothesized that self-reported poor medication adherence at the first prenatal visit would be associated with worse maternal glucose control and neonatal outcomes.
METHODS:
This is a prospective cohort study of insulin requiring pregnant women enrolled in a team-based perinatal diabetes program. The validated Morisky Medication Adherence Survey was administered to women at their initial prenatal visit. “Good” and “poor” self-reported adherence was defined as a score of 0 or 1 and between 2 and 8 respectively. The primary outcomes evaluated were HbA1c and a neonatal composite of hypoglycemia, large for gestational age, preterm birth and hyperbilirubinemia requiring phototherapy.
RESULTS:
Both groups had a similar proportion of women with type 1 and type 2 diabetes with younger women noted to have poor adherence. Women with good adherence had significantly better glucose control at time of delivery (HbA1c 5.68 vs 6.29, p=0.03). However, change in HbA1c from initial visit to delivery was similar between groups (-1.87 vs -1.88, p=0.98). There were no statistically significant differences in neonatal outcomes.
CONCLUSION:
Pregnant women with insulin requiring diabetes who report good medication adherence demonstrate improved glucose control at delivery compared to women who report poor adherence, although neonatal outcomes were similar. Regardless of reported adherence at initial visit, a team-based perinatal diabetes program achieves improved glucose control during pregnancy.
Details
- Title: Subtitle
- Is Self-Reported Insulin Adherence Associated With Maternal and Neonatal Outcomes? [23I]
- Creators
- Jessica Sheng - University of IowaSarah A. Wernimont - University of IowaDiedre Fleener - University of IowaFanta Traore - University of IowaCraig Syrop - University of IowaJanet Andrews - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Obstetrics and gynecology (New York. 1953), Vol.131(Supplement), pp.103-104S
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- DOI
- 10.1097/01.AOG.0000533449.15396.ed
- ISSN
- 0029-7844
- eISSN
- 1873-233X
- Language
- English
- Date published
- 05/2018
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9984697026602771
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