What do systematic reviews say?

Intensity of glycaemic control for women with gestational diabetes mellitus ‐ strict glycaemic targets vs less‐tight glycaemic targets (maternal outcomes)

Intensity of glycaemic control for women with gestational diabetes… showed no clear difference in hypertensive disorders of pregnancy (including pre‐eclampsia,… compared with less‐tight glycaemic targets (maternal outcomes) (low certainty).

• Different intensities of glycaemic control for women with gestational diabetes mellitus 2023 · Cochrane Headline outcomes only
  RR 1.16 [0.8, 1.69]
  2 studies · 1491 participants
  Low

Intervention not reported

The intervention may leads to lower hypertensive disorders of pregnancy (low certainty).

• Antenatal dietary supplementation with myo‐inositol for preventing gestational diabetes 2023 · Cochrane Headline outcomes only
  RR 0.34 [0.19, 0.61]
  5 studies · 1052 participants
  Low

Low‐GI dietary advice vs moderate‐ to high‐GI dietary advice (child outcomes)

• Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Universal screening vs risk‐factor screening

• Screening for gestational diabetes mellitus based on different risk profiles and settings for improving maternal and… 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Preconception care vs usual care

• Preconception care for diabetic women for improving maternal and infant health 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Continuous glucose monitoring system vs self‐monitoring of glucose

• Different methods and settings for glucose monitoring for gestational diabetes during pregnancy 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Metformin vs glibenclamide ‐ maternal outcomes

Metformin showed no clear difference in hypertensive disorders of pregnancy compared with glibenclamide ‐ maternal outcomes (moderate certainty).

• Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 0.7 [0.38, 1.3]
  3 studies · 508 participants
  Moderate

Myo‐inositol vs placebo

• Dietary supplementation with myo‐inositol in women during pregnancy for treating gestational diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Summary of findings: Low‐moderate GI diet vs moderate‐high GI diet (maternal outcomes)

It is very uncertain whether summary of findings: Low‐moderate GI diet changes hypertensive disorders of pregnancy: eclampsia compared with moderate‐high GI diet (maternal outcomes) (very low certainty).

• Different types of dietary advice for women with gestational diabetes mellitus 2017 · Cochrane Headline outcomes only
  RR 0.34 [0.01, 8.14]
  1 study · 83 participants
  Very low

Oral anti‐diabetic pharmacological therapies vs placebo (outcomes

It is very uncertain whether oral anti‐diabetic pharmacological therapies changes hypertensive disorders of pregnancy ‐ (any type) compared with placebo ‐ maternal outcomes (very low certainty).

• Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 1.24 [0.81, 1.9]
  1 study · 375 participants
  Very low

Primary care screening vs secondary care screening

Primary care screening showed no clear difference in hypertensive disorders of pregnancy: hypertension compared with secondary care screening (low certainty).

• Screening for gestational diabetes mellitus based on different risk profiles and settings for improving maternal and… 2017 · Cochrane Headline outcomes only
  RR 1.41 [0.77, 2.59]
  1 study · 690 participants
  Low

Insulin vs anti‐diabetic agent

Insulin probably leads to higher hypertensive disorders of pregnancy (not defined) compared with anti‐diabetic agent (moderate certainty).

• Insulin for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 1.89 [1.14, 3.12]
  4 studies · 1214 participants
  Moderate

Metformin vs insulin

It is very uncertain whether maternal outcomes: oral anti‐diabetic agent (metformin) changes hypertensive disorders of pregnancy: pre‐eclampsia compared with insulin (very low certainty).

• Oral anti‐diabetic agents for women with established diabetes/impaired glucose tolerance or previous gestational… 2017 · Cochrane Headline outcomes only
  RR 0.63 [0.33, 1.2]
  2 studies · 227 participants
  Very low

Summary of findings: Energy‐restricted diet vs no energy‐restricted diet (maternal outcomes)

Summary of findings: Energy‐restricted diet showed no clear difference in hypertensive disorders of pregnancy: pre‐eclampsia compared with no energy‐restricted diet (maternal outcomes) (low certainty).

• Different types of dietary advice for women with gestational diabetes mellitus 2017 · Cochrane Headline outcomes only
  RR 1 [0.51, 1.97]
  1 study · 117 participants
  Low

Self‐monitoring vs intermittent glucose monitoring

It is very uncertain whether self‐monitoring changes hypertensive disorders of pregnancy: pre‐eclampsia compared with periodic glucose monitoring (very low certainty).

• Different methods and settings for glucose monitoring for gestational diabetes during pregnancy 2017 · Cochrane Headline outcomes only
  RR 0.17 [0.01, 3.49]
  1 study · 58 participants
  Very low

Glibenclamide vs acarbose ‐ maternal outcomes

The review found no eligible studies for this question.

• Oral anti‐diabetic pharmacological therapies for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Probiotics vs placebo

Probiotics leads to higher hypertensive disorders of pregnancy (pre‐eclampsia) compared with placebo (high certainty).

• Probiotics for preventing gestational diabetes 2021 · Cochrane Headline outcomes only
  RR 1.85 [1.04, 3.29]
  4 studies · 955 participants
  High

Dietary advice vs standard‐of‐care therapy

Dietary advice interventions showed no clear difference in hypertensive disorders of pregnancy (pre‐eclampsia) compared with standard care (maternal outcomes) (low certainty).

• Dietary advice interventions in pregnancy for preventing gestational diabetes mellitus 2017 · Cochrane Headline outcomes only
  RR 0.61 [0.25, 1.46]
  2 studies · 282 participants
  Low

Adverse event outcomes for dietary combined with physical activity interventions vs standard‐of‐care therapy

Combined diet and exercise interventions showed no clear difference in hypertensive disorders of pregnancy (pre‐eclampsia) compared with standard care (mother) (low certainty).

• Combined diet and exercise interventions for preventing gestational diabetes mellitus 2017 · Cochrane Headline outcomes only
  RR 0.98 [0.79, 1.22]
  8 studies · 5366 participants
  Low

Lifestyle interventions vs control ‐ Maternal outcomes

Lifestyle interventions showed no clear difference in hypertensive disorders of pregnancy (pre‐eclampsia) compared with control ‐ Maternal outcomes (low certainty).

• Lifestyle interventions for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
  RR 0.7 [0.4, 1.22]
  4 studies · 2796 participants
  Low