Implications For Care And Research

Much progress has been made in the past decades in the medical management of diabetic pregnancy. Unfortunately, research tells us that pre-preg-

nancy counselling has a limited effect in changing contraceptive behaviour in women with diabetes. Unplanned pregnancies therefore remain a major problem, leading to an excessive rate of spontaneous abortions and congenital malformations among women with diabetes. Further research into possible ways of improving the efficacy of pre-pregnancy programmes are warranted. Such studies should take into account socio-economic, cultural and ethnic factors that can strongly influence a woman's acceptance, understanding and compliance with restrictions imposed by a diabetic preg-

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