Interventions to enhance pre-pregnancy care for women with Type 2 diabetes: a systematic review of the literature

TY - JOUR

T1 - Interventions to enhance pre-pregnancy care for women with Type 2 diabetes: a systematic review of the literature

AU - Hopkins, Lily

AU - Forbes, Angus

AU - Anderson, Janet

AU - Bick, Debra

AU - Brackenridge, Anna

AU - Banerjee, Anita

AU - Chamley, Mark

AU - Chua, Kia-Chong

AU - Flynn, Angela

AU - Hunt, Katharine F.

AU - Murphy, Helen

AU - Rogers, Helen

AU - White, Sara

AU - Winkley, Kirsty

AU - Forde, Rita

N1 - Funding Information: We would like to acknowledge National Institute for Health Research, UK for funding the PREPARED study trial from which this review originates. Publisher Copyright: © 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

PY - 2023/8

Y1 - 2023/8

N2 - Aims: The aim of the study was to examine the content and impact of interventions that have been used to increase the uptake of pre-pregnancy care for women with type 2 diabetes, and their impact on maternal and fetal outcomes. Methods: A systematic search of multiple databases was conducted in November 2021, and updated July 2022, to identify studies assessing interventions to enhance pre-pregnancy care for women with type 2 diabetes. Over 10% of articles were screened by two reviewers at title and abstract phase, after which all selected full-text articles were screened by two reviewers. Quality assessment was conducted using the Critical Appraisal Skills Programme checklist for cohort studies. Meta-analysis was not possible due to study heterogeneity; therefore, narrative synthesis was conducted. Results: Four eligible cohort studies were identified. The conclusions able to be drawn by this review were limited as women with type 2 diabetes (n = 800) were in the minority in all four studies (35%–40%) and none of the interventions were exclusively tailored for them. The uptake of pre-pregnancy care was lower in women with type 2 diabetes (8%–10%) compared with other participant groups in the studies. Pregnancy preparation indicators generally improved among all groups exposed to pre-pregnancy care, with varying impact on pregnancy outcomes. Conclusions: This review demonstrates that previous interventions have had a limited impact on pre-pregnancy care uptake in women with type 2 diabetes. Future studies should focus on tailored interventions for improving pre-pregnancy care for women with type 2 diabetes, particularly those from ethnic minorities and living in poorer communities.

AB - Aims: The aim of the study was to examine the content and impact of interventions that have been used to increase the uptake of pre-pregnancy care for women with type 2 diabetes, and their impact on maternal and fetal outcomes. Methods: A systematic search of multiple databases was conducted in November 2021, and updated July 2022, to identify studies assessing interventions to enhance pre-pregnancy care for women with type 2 diabetes. Over 10% of articles were screened by two reviewers at title and abstract phase, after which all selected full-text articles were screened by two reviewers. Quality assessment was conducted using the Critical Appraisal Skills Programme checklist for cohort studies. Meta-analysis was not possible due to study heterogeneity; therefore, narrative synthesis was conducted. Results: Four eligible cohort studies were identified. The conclusions able to be drawn by this review were limited as women with type 2 diabetes (n = 800) were in the minority in all four studies (35%–40%) and none of the interventions were exclusively tailored for them. The uptake of pre-pregnancy care was lower in women with type 2 diabetes (8%–10%) compared with other participant groups in the studies. Pregnancy preparation indicators generally improved among all groups exposed to pre-pregnancy care, with varying impact on pregnancy outcomes. Conclusions: This review demonstrates that previous interventions have had a limited impact on pre-pregnancy care uptake in women with type 2 diabetes. Future studies should focus on tailored interventions for improving pre-pregnancy care for women with type 2 diabetes, particularly those from ethnic minorities and living in poorer communities.

UR - http://www.scopus.com/inward/record.url?scp=85158170768&partnerID=8YFLogxK

U2 - 10.1111/dme.15105

DO - 10.1111/dme.15105

M3 - Review article

SN - 0742-3071

VL - 40

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 8

M1 - e15105

ER -