A recent study has shown that a regional preconception care programme was associated with improved pregnancy preparation and reduced risk of adverse pregnancy outcome in type 1 and type 2 diabetes. Preconception care had benefits beyond improved glycaemic control and was a stronger predictor of pregnancy outcome than maternal obesity, ethnicity, or social  disadvantage [1].

Another study of the cost benefits of preconception care used a combination of literature review, expert opinion and surveys of medical care to estimate the costs and clinical consequences of preconception care compared to no preconception care [2]. The authors calculated that, from a combination of reduced antenatal care costs and fewer adverse maternal and neonatal outcomes, there was a saving of 1.86 US dollars for each dollar spent.

A third study of 24 women with preconception care and 74 women with no preconception care found a net cost saving of $34,000 per patient with preconception care [3].  This was due to less hospitalisation during pregnancy, a shorter stay following delivery, and both less intensity of and a shorter inpatient stay for the baby. They found no overall increase in out patient visits in with preconception care.

1. Murphy HR, Roland JM, Skinner TC, Simmons, D, Gurnell E, Moorish NJ, Soo S-C, Kelly S, Randall J, Tompsett S, and Temple RC. Effectiveness of a regional prepregnancy care program in women with type 1 and type 2 diabetes: benefits beyond glycemic control. Diabetes Care 2010; 33:2514–2520.

2. Elixhauser A, Weschler JM, Kitzmiller JL, Marks JS, Bennet Jr HW, Coustan DR, Gabbe SG, Herman WH, Kaufmann RC, Ogata ES et al. Cost-benefit analysis of preconception care for women with established diabetes mellitus. Diabetes Care 1993; 16: 1146-1157.

3. Herman WH, Janz NK, Becker MP, Charron-Prochownik. Diabetes and pregnancy. Preconception care, pregnancy outcomes, resource utilisation and costs. J Reprod Med 1999; 44: 33-8.