Prevalence of Preconception Lifestyle Behaviors Between Women With and Without Diabetes

Objective: The purpose of this paper is to describe lifestyle and reproductive behaviors of preconception women and determine if the likelihood of healthy preconception behaviors differs between women with and without diabetes.

Methods: Secondary analysis of cross-sectional data from the Behavioral Risk Factor Surveillance System (2002 and 2004) was conducted. Subjects were 18-44 year old, non-pregnant, fertile women (n=60,365), grouped into one of two categories: not pregnant- without diabetes (Non-Diabetic; n=57,436), and not pregnant - with diabetes (Diabetic; n=2,929). Logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI) for behavioral characteristics using non-pregnant, non-diabetic women as the referent group.

Results: When compared to non-diabetic women, diabetic women were significantly more likely not to use any birth control (40.5, 95% CI: 37.3, 43.8 versus 33.4, 95% CI: 32.7, 34.1) and significantly less likely to use more effective birth control (i.e., hormonal) methods (26.8, 95% CI: 23.9, 30.0 versus 34.5, 95% CI: 33.8, 35.2). After adjusting for demographic characteristics, significant differences between birth control use between diabetic and non-diabetic women disappeared (aPOR 1.12, 95% CI: 0.97, 1.29). Diabetic women were also less likely than non-diabetic women to drink any alcohol (aPOR 0.65, 95% CI: 0.56, 0.76), and binge drink (aPOR 0.73, 95% CI: 0.58, 0.91), although 2.7 times more likely to be obese (aPOR 2.70, 95% CI: 2.30, 3.14).

Conclusions: Public health campaigns and clinical practices need to address this important concern, with additional research needed regarding inequities between women with and without diabetes.