Knowledge about preconception care in French women with type 1 diabetes

To assess the knowledge about preconception care among women with type 1 diabetes of childbearing age and to identify factors that may be associated with the absence of preconception care. All women of childbearing age with type 1 diabetes who were seen in 11 Diabetes Centers between December 1 and 12, 2003 were included. An anonymous dual questionnaire was proposed to these women and their consulting diabetologists. One hundred and thirty-eight women were included in the study. The main reported sources of information about pregnancy were the diabetologist (78%) and/or specific leaflets (42%). Although 85% of the women declared having received information about preconception care, 48% were unaware of the risk of congenital malformations and 41% feared for neonatal diabetes. However, 82% of the women thought that a level of HbA1c below 7% was a target to achieve before conception. In multivariate analysis, onset of diabetes before the age of 15 was associated with the knowledge that diabetes may be associated with complications during pregnancy; the use of contraception was associated with knowledge about preconception care; a high educational level was associated with knowledge that complications are avoidable and that good glycemic control is mandatory before conception. French women with type 1 diabetes, although followed by diabetologists, have major knowledge defects concerning the risks associated with pregnancy. This is the first step towards decreasing the rate of unplanned pregnancies in women with type 1 diabetes.