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Perspectives

Diabetes in women of childbearing age. Contraceptive options and pregnancy planning

Dhanya Sanjeev, Ann Poynten, Antonia Shand

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© waranyu/STOCK.ADOBE.COM

Abstract

For women with diabetes, optimal glycaemic control, particularly in the periconception period, is associated with improved pregnancy outcomes. It is important that women with diabetes plan pregnancies so that measures can be taken to achieve optimal metabolic control before conception. A key feature of pregnancy planning is effective contraception.

Key Points

  • Effective contraception in women with diabetes is important to reduce the risk of unintended pregnancies and adverse pregnancy outcomes.
  • Long-acting reversible contraceptives such as intrauterine devices and long-acting subdermal implants are highly effective and suitable for most women with diabetes.
  • Optimisation of glycaemic control before conception is essential to reduce the risk of fetal abnormalities and adverse pregnancy outcomes.
  • Screening for diabetes-related complications and optimising maternal blood pressure should occur before conception; medications should be reviewed before conception to avoid teratogenic agents.
  • High-dose (5mg daily) folic acid should commence at least one month before conception.

Figures

© waranyu/STOCK.ADOBE.COM
© waranyu/STOCK.ADOBE.COM