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Publication, Part of

National Pregnancy in Diabetes Audit Report - 2014

Audit
Publication Date:
Geographic Coverage:
England, Wales
Geographical Granularity:
Country, Regions, NHS Trusts, Hospital Trusts, Hospital and Community Health Services
Date Range:
01 Jan 2014 to 31 Dec 2014

Summary

The National Pregnancy in Diabetes (NPID) Audit is part of the National Diabetes Audit (NDA) programme, and is commissioned by The Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit programme (NCA).

The NPID 2014 report is the second annual report from a continuous audit of the quality of care and outcomes for women with diabetes who become pregnant.

The audit looks at three key questions: - Were women adequately prepared for pregnancy? - Were adverse maternal outcomes minimised? - Were adverse fetal/infant outcomes minimised?

This report includes data on women with diabetes who became pregnant where their pregnancy was completed between 1 January 2014 and 31 December 2014 and the data was submitted to the audit by 12 February 2015. 150 hospitals/Trusts submitted data to the 2014 audit.

In addition to the National report, the NPID Audit has produced reports presenting key findings for nine ONS Regions in England, and for Wales. These reports show comparisons with the national data for England and Wales.

Adverse measures such as stillbirth and congenital anomalies are too infrequent to report annually at this level, and are therefore reported only in the National Summary report.

Highlights

The NICE guideline for diabetes and pregnancy recommends that women with diabetes who are planning to become pregnant:

  • take 5mg/day folic acid prior to becoming pregnant and until 12 weeks of gestation to reduce the risk of having a baby with a neural tube defect.
  • aim to maintain HbA1c below 48 mmol/mol(recommendation from February 2015 - previously 43 mmol/mol).

The audit found that:

  • Less than half of women in the audit were taking folic acid in any dose prior to pregnancy (41.9 per cent). 
  • Only 15.4 per cent of women with Type 1 diabetes and 35.8 per cent of women with Type 2 diabetes had a first trimester HbA1c measurement below 48 mmol/mol.
  • 6.2 per cent of women were taking potentially harmful medications (statins, ACE inhibitors and ARBs)  at the time of conception
  • 9.2 per cent of women with Type 2 diabetes became pregnant while taking a potentially hazardous glucose lowering medication.
  • Combined 2013 and 2014 audit data confirm high rates of adverse outcomes - 12.8 stillbirths per 1000 live and stillbirths, 7.6 neonatal deaths per 1000 live births and 44.2 anomalies per 1000 live and stillbirths.
  • More than one third of women (34.3 per cent) had babies that were large for gestational age.
  • Two-thirds (66.6 per cent) of babies were able to remain with their mothers and did not need intensive or special neonatal care.

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Last edited: 15 September 2020 9:53 am