Reproductive health and preconception counseling awareness in adolescents with diabetes: what they don't know can hurt them.

PURPOSE: This study explored the awareness of issues related to diabetes and pregnancy, preconception counseling (PC), and contraception in adolescent women with type 1 diabetes (T1D).
METHODS: A descriptive-qualitative method was used to collect open-ended data during a telephone interview on reproductive health by same-gender research assistants. Eighty subjects were recruited from multiple sites (mean age = 17.6 +/- 1.0 year; range, 16-20). Questions focused on 2 themes, awareness of diabetes and reproductive health (pregnancy, PC, birth control) and where to seek information about these issues. Responses were written verbatim. Pattern recognition detected common themes. Results were cross-checked for interrater reliability.
RESULTS: Overall, the response "don't know" or "never heard about it" was most frequently given. Most teens in this sample were unaware of the term preconception counseling; 65% (n = 52) indicated they knew nothing about PC. Many were not aware of the risks of pregnancy-related complications in women with diabetes. One fourth of the teens were aware of preplanning a pregnancy and the importance of good metabolic control. Many knew where to seek information about diabetes and pregnancy, and birth control.
CONCLUSIONS: This sample of teens lacked awareness of pregnancy-related complications with diabetes, the term and role of PC in preventing these complications, and the importance for women with diabetes to use a highly effective birth control method for preventing an unplanned pregnancy. Because of its implications for future reproductive health behavior and preventing unplanned pregnancies and complications, during their routine clinic visits, it is imperative for health professionals to raise these issues with their adolescent female patients.