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Pre‐pregnancy health of women with pre‐existing diabetes or previous gestational diabetes: Analysis of pregnancy risk factors and behavioural data from a digital tool
Open accessAbstract
Aims: To examine health behaviours and risk factors in women with pre‐existing diabetes or previous gestational diabetes mellitus who are planning pregnancy. Methods: Health behaviour, risk factor and demographic data obtained from a digital pregnancy planning advisory tool (Tommy's charity UK) were analysed. Descriptive statistical analysis was performed, stratified by diabetes type. Results: Data from 84,359 women, including 668 with type 1 diabetes, 707 with type 2 diabetes and 1785 with previous gestational diabetes obtained over a 12‐month period (September 2019–September 2020) were analysed. 65%, 95%CI (61,68%) of women with type 2 diabetes and 46%, 95%CI (43,48%) with previous gestational diabetes were obese (BMI ≥30 kg/m 2), compared with 26%, 95%CI (26,26%) without diabetes. Use of folic acid supplements was low; 41%, 95%CI (40,41%) of women without diabetes and 42%, 95%CI (40,45%) with previous gestational diabetes reported taking folic acid (any dose) while 47%, 95%CI (43.50%) women with type 1 diabetes and 44%, 95%CI (40,47%) women with type 2 diabetes respectively reported taking the recommended dose (5 mg). More women with type 1 diabetes and type 2 diabetes reported smoking (20%, 95%CI [17,23%] and 23%, 95%CI [20,26%] respectively) and taking illicit/recreational drugs (7%, 95%CI [6,10%] and 9%, 95% CI [7,11%]) compared to women without diabetes (smoking 17%, 95% CI [16,17%], drug use 5%, 95%CI [5,5%]). Alcohol consumption, low levels of physical activity and of fruit and vegetable intake were also evident. Conclusions: This study highlights the potential of online pregnancy planning advisory tools to reach high‐risk women and emphasises the need to improve pre‐pregnancy care for women with pre‐existing diabetes and previous gestational diabetes, many of whom are actively seeking advice. It is also the first to describe pre‐pregnancy health behaviours in women with previous gestational diabetes.
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Within the United Kingdom, data specific to preconception perceptions, health knowledge, and behaviours in women with GDM is very limited.
“Within the United Kingdom, data specific to preconception perceptions, health knowledge, and behaviours in women with GDM is very limited [24] yet essential for effective development of interventions for the prevention of GDM, and to support informed pregnancy experiences, including engaging in proactive health behaviours before conception.”
From Preconception Perceptions, Knowledge and Behaviours of Women With Gestational Diabetes Mellitus: A Qualitative Study (2026) · cites this paper as [24]
The Introduction (page unavailable) says that, to the authors’ knowledge, there were no pre-pregnancy health-behaviour data for women with previous gestational diabetes. This supports the claim about limited behavioural data, but the paper does not make the same claim about preconception perceptions or health knowledge, or limit that evidence gap specifically to the United Kingdom. (LLM, conf=0.85)
Experimental — accuracy not yet measuredLimited awareness of GDM prior to pregnancy is well documented, and the findings of this study are consistent with existing literature indicating GDM is often first considered at the point of screening or diagnosis.
“Limited awareness of GDM prior to pregnancy is well documented, and the findings of this study are consistent with existing literature indicating GDM is often first considered at the point of screening or diagnosis [24].”
From Preconception Perceptions, Knowledge and Behaviours of Women With Gestational Diabetes Mellitus: A Qualitative Study (2026) · cites this paper as [24]
The Introduction says there are no preconception-specific guidelines for women with previous gestational diabetes, and the Discussion describes suboptimal pregnancy preparation in that group. Neither passage addresses awareness of GDM before pregnancy or whether women first consider it at screening or diagnosis; searches for awareness and screening or diagnosis found no passage establishing those points. (LLM, conf=0.76)
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Cites
Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis
Flenady, V., Koopmans, L., Middleton, P., Frøen, J. F., Smith, G. C., Gibbons, K., Coory, M., Gordon, A., Ellwood, D., McIntyre, H. D., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62233-7 · Cited by 1,247
Effectiveness of a Regional Prepregnancy Care Program in Women With Type 1 and Type 2 Diabetes
Murphy, H. R., Roland, J. M., Skinner, T. C., Simmons, D., Gurnell, E., Morrish, N. J., Soo, S.-C., Kelly, S., Lim, B., Randall, J., et al. (2010) · Diabetes Care · doi:10.2337/dc10-1113 · Cited by 186
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Payne, E., Schoenaker, D., Turner, K., Murphy, H. R., Skouteris, H., Ismail, K., Silverio, S. A., & Benton, M. (2026) · Health Expectations · doi:10.1111/hex.70617 · Cited by 4
“Addressing these preconception knowledge gaps is therefore critical to designing acceptable, well‐timed and engaging interventions, and to supporting informed pregnancy experiences through shared decision‐making, anticipation of care pathways and potentially reduced distress if GDM occurs [24, 28].”
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Metadata
- Authors
- Flynn, A. C., Robertson, M., Kavanagh, K., Murphy, H. R., Forde, R., Stephenson, J., Poston, L., & White, S. L.
- Affiliations
- King's College London (GB)
- University of Strathclyde (GB)
- University of East Anglia (GB)
- University College London (GB)
- Corresponding author
- White, Sara L.
- ORCID
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2022-11-30
- Volume
- 40
- Issue
- 2
- Pages
- e15008-e15008
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- PMC
- PMC10100236
- OpenAlex
- W4309444844
- Cited by
- 5
- References
- 2
- Citations by year
- 2026: 3 · 2024: 1 · 2022: 1
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetic Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by-nc)
- Research Portal (King's College London) (submittedVersion, cc-by-nc)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- British Heart Foundation (PG/13/38/30289)
- Rosetrees Trust
- Medical Research Council (MR/L002477/1)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Keywords
- gestational diabetes mellitus, preconception care, pregnancy planning, type 1 diabetes, type 2 diabetes, obesity, folic acid supplementation, smoking, illicit drug use, alcohol consumption, physical activity, fruit and vegetable intake, pregnancy risk factors, digital health tools, online health advice, high-risk pregnancy
- MeSH terms
- Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Folic Acid, Humans, Male, Pregnancy, Risk Factors, Diabetes, Gestational
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