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

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/m2), 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.