Key result
Team-based preconception care linked to a ~106% increase in achieving target HbA1c versus conventional care.
Why the study?
Preconception care is essential for women with diabetes, but the effectiveness of a team-based approach involving both maternal-fetal medicine specialists and endocrinologists has not been well established.
Does team-based preconception care improve the achievement of key preconception care targets in women with pregestational diabetes compared to conventional care?
Cohort (n=135)
No
Does team-based preconception care improve the achievement of key preconception care targets in women with pregestational diabetes compared to conventional care?
Team-based preconception care involving both maternal-fetal medicine specialists and endocrinologists significantly improves glycemic control and folic acid use in women with pregestational diabetes.
Answers are grounded in this paper and cite their sources.
May support team-based preconception care for glycemic targets in diabetes; leaves open perinatal benefits without randomized confirmation.
BACKGROUND: Preconception care (PCC) is essential for women with diabetes to reduce adverse perinatal outcomes, including congenital anomalies. However, the effectiveness of a team-based PCC approach involving both maternal-fetal medicine (MFM) specialists and endocrinologists has not been well established. This study aimed to evaluate whether team-based PCC improves the achievement of key PCC targets compared with conventional PCC. METHODS: This retrospective cohort study included women with pregestational diabetes who delivered at a tertiary perinatal center between 2014 and 2022. Team-based PCC was defined as ≥6 months of preconception care jointly provided by MFM specialists and endocrinologists, whereas conventional PCC was provided by endocrinologists alone. Primary outcomes were HbA1c levels, achievement of the target HbA1c (<6.5%), and preconceptional folic acid use at the first prenatal visit. Secondary outcomes included maternal characteristics and perinatal outcomes. RESULTS: A total of 135 pregnancies were analyzed (team-based PCC: n=53; conventional PCC: n=82). Maternal age was similar between the groups; however, women in the team-based PCC group had lower rates of obesity and primiparity. The team-based PCC group showed significantly lower HbA1c levels (6.4±1.0% vs 7.4±1.6%, p<0.0001) and higher rates of achieving the target HbA1c <6.5% (62% vs 32%, p=0.0005). Preconceptional folic acid use was also more frequent (66% vs 7%, p<0.0001). The first prenatal visit occurred earlier in the team-based PCC group. Cesarean delivery and large-for-gestational-age rates were lower in the team-based PCC group. Subgroup analyses suggested comparable or greater benefits of team-based PCC in women with type 2 diabetes. CONCLUSIONS: Team-based PCC involving MFM specialists and endocrinologists significantly improved the achievement of key PCC targets and may contribute to improved perinatal outcomes. This collaborative approach should be promoted for women with diabetes of reproductive age.
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Suga et al. (2026) conducted a cohort in Pregestational diabetes (n=135). Team-based preconception care (MFM specialists and endocrinologists) vs. Conventional preconception care (endocrinologists alone) was evaluated on Achievement of target HbA1c (<6.5%) at the first prenatal visit (p=<0.0001). Team-based preconception care involving maternal-fetal medicine specialists and endocrinologists significantly increased the rate of achieving target HbA1c <6.5% (66% vs 32%) compared to conventional care.
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