Interventions to enhance pre‐pregnancy care for women with type 2 diabetes: A systematic review of the literature

Abstract

AbstractAimsThe 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.MethodsA 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.ResultsFour 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.ConclusionsThis 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.