The Need of Women with Type 1 Diabetes for Pregnancy-Related Care in China: An Online Questionnaire Study

Background: Pregnancy Related Care (PRC) could reduce the risk of adverse pregnancy outcomes in women with type 1 diabetes (T1D). Little was known about the need of them in China. We aimed to identify their need for PRC. Methods: It was a cross-sectional study on women with T1D by an online questionnaire based on previous in-depth interviews. The questionnaire was advertised via patient community and Wechat. The survey ended when the sample size was reached. The data were analyzed in SPSS 19.0. Results: The survey was conducted from Dec 26, 2016 to Jan 18, 2018. We received 385 responses from 28 provinces of China. Among them, 72.7% were aged 21∼35; 53.5% with T1D for over 5 years; 84.4% had annual income less than $10,000 and 61.6% spent over 30% income on T1D management; 66.0% and 37.4% were on MDI and CSII, respectively. The results were as below. 1) Current status of PRC: only 23.4% reported HbA1c<6.5%; 33.0% ever got pregnant and 48.4% with adverse pregnancy outcomes; only 12.5% thought they got enough knowledge on PRC; 90.4% had worries for pregnancy, including complications, inheritance of T1D, cost and discrimination; 94.5% were willing to attend PRC program. 2) Doctor-patient relationship: 75.0% went to tertiary hospitals for T1D; 80.5% were satisfied with the doctors; 72.5% reported less than 10 minutes per visit while 76.9% asked for over 10 minutes for better communication; 76.8% gained confidence for pregnancy after visit; 84.2% suggested PRC be provided in a multiple disciplinary team. 3) Social support: 86.2% expressed T1D influenced their decision of marriage and childbearing; 44.9% concealed T1D from their family about T1D and 30.5% didn’t think the family would support the decision of pregnancy; 80.3% longed to share experience among peers and 78.7% were more confident after sharing. Conclusion: Women with T1D had various unmet need for PRC, but current practice of PRC was lacking in China. The role of professional and social support should be enhanced to relieve their stress on pregnancy. Disclosure C. Wang: None. S. Luo: None. X. Zheng: None. S. Xiong: None. J. Yan: None. D. Yang: None. L. Qiu: None. B. Yao: None. J. Weng: None. Funding Guangdong Province Science and Technology Program (2018A070701019); National Health and Family Planning Commission of the People's Republic of China (201502011); World Diabetes Foundation (14-921)