Maternal diabetes in pregnancy can negatively impact fetal well-being and contribute to adverse pregnancy outcomes. Much of the morbidity associated with diabetes in pregnancy can be minimized with tight glucose control. A number of studies in non-pregnant populations have highlighted the feasibility, acceptability and efficacy of text messaging interventions for improving diabetic compliance and control. This study will investigate whether a text messaging intervention is feasible and effective in an urban, diabetic, obstetric clinic and whether this intervention can improve compliance with diabetes care, glucose control and pregnancy outcomes. The study will also assess satisfaction with the intervention itself.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
30
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Patient Satisfaction
Patient satisfaction with the texting intervention as measured by a post-study survey
Time frame: date of enrollment up to 12 weeks post partum
Compliance with Obstetric and Diabetes Care
Proportion of prenatal visits attended, proportion of assigned blood glucose logs sent to clinic for review, proportion of assigned blood glucose values checked, compliance with attendance at postpartum visit.
Time frame: OB screening visit through 12 weeks postpartum
Efficacy measures
Measuring the proportion of blood glucose values within the target range each week; mean fasting and postprandial blood glucose values measured weekly; change in hemoglobin A1C (for pregestational diabetics) from initiation of care to the third trimester
Time frame: Diabetes diagnosis through 12 weeks postpartum
Healthcare Utilization Measures
Measuring the number of visits to the perinatal evaluation center related to diabetes care and the total number of antepartum hospitalizations.
Time frame: Screening OB visit through 12 weeks postpartum
Maternal Outcomes
Measuring the mode of delivery (spontaneous vaginal, operative vaginal, cesarean section), complications of delivery (shoulder dystocia, postpartum hemorrhage, third and fourth degree lacerations), and length of hospital stay.
Time frame: Delivery date through 12 weeks postpartum
Neonatal Outcomes
Measuring fetal demise; neonatal death; birthweight; large for gestational age; small for gestational age; APGAR scores; umbilical cord blood gas; NICU admission; respiratory distress; hypoglycemia; hyperbilirubinemia; length of hospital stay
Time frame: Neonate delivery through 12 weeks postpartum
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