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August 13, 2018Cochrane libraryOpen Access

Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews

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Key result

Lifestyle interventions compared to usual care probably reduce the risk of large-for-gestational age babies (RR 0.60; 95% CI 0.50-0.71), though they may increase the risk of induction of labor.

Why the study?

Do various treatment interventions improve health outcomes for women with gestational diabetes mellitus and their babies?

Population

17,984 women with gestational diabetes mellitus, 16,305 babies, and 1441 children from 128 RCTs across 10…

Comparison

Various treatments for gestational diabetes… vs Usual care, control, or alternative therapies.

Design

Systematic_review

Authors

RMRuth MartisCCCaroline A CrowtherESEmily Shepherd

Discussion

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Overview

Lifestyle interventions may reduce large-for-gestational-age infants in GDM; leaves open optimal components and comparative effectiveness of alternatives.

Study Design

Type

Systematic Review (n=17,984)

Structured PICO

Do various treatment interventions improve health outcomes for women with gestational diabetes mellitus and their babies?

P
Population
17,984 women with gestational diabetes mellitus and their babies included in 128 randomized controlled trials from 10 high-quality systematic reviews.
I
Intervention
Various treatments for gestational diabetes mellitus including lifestyle interventions, exercise, insulin, oral therapy, diet, myo-inositol, and intensive management.
C
Comparator
Usual care, control, or alternative therapies (e.g., oral therapy vs insulin).
O
Outcome
Maternal and neonatal health outcomes including large-for-gestational age, induction of labour, hypertensive disorders of pregnancy, and perinatal mortality.

Main Result

Relative Risk: 0.6 (95% CI 0.5–0.71)

Lifestyle changes are the only intervention showing possible health improvements (fewer large-for-gestational-age babies) for women with GDM, though they may increase labor inductions, and evidence for most other treatments remains insufficient.

Limitations

  • Insufficient high-quality evidence about the effects on health outcomes for many comparisons
  • Very limited information on long-term health and health services costs
  • Insufficient high-quality evidence for many comparisons

Cite This Study

Martis et al. (2018) conducted a systematic review in Gestational diabetes mellitus (n=17,984). Lifestyle interventions vs. Usual care was evaluated on Large-for-gestational age (RR 0.60, 95% CI 0.50 to 0.71). Lifestyle interventions compared to usual care probably reduce the risk of large-for-gestational age babies (RR 0.60; 95% CI 0.50-0.71), though they may increase the risk of induction of labor.

synapsesocial.com/papers/6a76fa39df493903fd1e9291https://doi.org/10.1002/14651858.cd012327.pub2
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pregnancy Weight Gain and Risk of Neonatal Complications2006 · 194 citations
  2. 2Acute effects of physical exercise in type 2 diabetes: A review2014 · 105 citations
  3. 3A review of current treatment strategies for gestational diabetes mellitus2015 · 88 citations
  4. 4Insulin analogues in the treatment of diabetes in pregnancy2012 · 22 citations
  5. 5Vitamin D status during pregnancy2011 · 120 citations