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Gestational diabetes mellitus (GDM) is a common complication in pregnancy. Its early identification through targeted screening and timely management with lifestyle or pharmacological interventions is essential to optimise outcomes. Current evidence on GDM management is limited, with few studies directly comparing conservative measures with pharmacological therapy. This review evaluates the impact of conservative versus pharmacological management on maternal and neonatal outcomes. Databases and grey literature were searched, and identified studies were screened using pre-defined eligibility criteria. Data were extracted from the included studies, and study quality was appraised using the Critical Appraisal Skills Programme (CASP) tool. Maternal and neonatal outcomes were pooled in a meta-analysis. Conservative management was associated with a 30% reduction in adverse maternal outcomes (risk ratio (RR) 0.70, 95% confidence interval (CI): 0.50-0.98, p=0.04) and a 26% reduction in adverse neonatal outcomes (RR: 0.74, 95% CI: 0.60-0.96, p=0.02). Subgroup analyses revealed no significant differences between pharmacological therapies. Overall, conservative management of GDM appears to improve both maternal and neonatal outcomes compared to pharmacological management. These findings support lifestyle-based interventions as a safe and effective option, though further research is needed to confirm clinical benefits and refine clinical guidance.
Ikwuanusi et al. (Wed,) studied this question.
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