Background:
It is well known that uncontrolled diabetes confers a 3 fold risk for major congenital malformations.In 1982 ,Dr John Kitzmiller organized a pilot project funded jointly by March of Dimes and the State Dept of Health, Maternal/Child Branch at Children's Hospital in San Francisco comparing outcomes for women with type 1 diabetes who received preconception care vs those who began care in or after the first trimester. This study showed preconception care reduced the risk of malformations to 1.7% compared to 11% with no preconception care. These findings led to a State funded Regional Program (The California Diabetes and Pregnancy Program- CDAPP) which has provided diabetes and pregnancy training for providers in over 200 affiliates in all 10 Perinatal Regions in California since 1984.The affiliate programs are referred to as Sweet Success Programs.

Objectives:
This abstract will descibe the results of data collected from Sweet Success affiliates from 2001 to 2006 concerning preconception care for women with type 1 and type 2 diabetes, We will share issues raised by this data and strategies for improvement.

Methods:
Retrospective review of data collected by the California diabetes and pregnancy program Data System 2001-2006

Results:
Percent reporting preconception care
Entry to care - preconception or post conception (prenatal)
A1C at entry to prenatal care
congenital malformation rate
BMI @ entry to care compared to prepregnancy BMI


Conclusion and implications for practice:
Preconception care is effective in reducing risks associated with diabetes
Preconception care is lacking -even in this population
Strategies to increase preconception care will be discussed