What do systematic reviews say?

58 questions · 59 findings · 34 reviews · Pregnancy and Childbirth

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No studies found 5 · 8.5%GRADE not reported 10 · 16.9%Very low 10 · 16.9%Low 24 · 40.7%Moderate 6 · 10.2%High 4 · 6.8%

Very tight vs tight‐moderate glycaemic control (infant outcomes)

Pre‐eclampsia · pregnant women with pre‐existing type 1 diabetes

The review found no eligible studies for this question.

1 finding from 1 review

Different intensities of glycaemic control for pregnant women with pre‐existing diabetes 2016 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Tight vs moderate glycaemic control (maternal outcomes)

Pre‐eclampsia · pregnant women with pre‐existing type 1 diabetes

It is very uncertain whether tight changes pre‐eclampsia compared with moderate glycaemic control (maternal outcomes) (very low certainty).

1 finding from 1 review

Different intensities of glycaemic control for pregnant women with pre‐existing diabetes 2016 · Cochrane Headline outcomes only
RR 5.29 [0.23, 122.91]
1 study · 45 participants
Very low

Tight‐moderate vs less‐tight glycaemic targets (maternal outcomes)

Pre‐eclampsia · pregnant women with pre‐existing type 1 diabetes

Tight‐moderate may leads to lower pre‐eclampsia compared with loose glycaemic control (maternal outcomes) (low certainty).

1 finding from 1 review

Different intensities of glycaemic control for pregnant women with pre‐existing diabetes 2016 · Cochrane Headline outcomes only
RR 0.11 [0.01, 0.99]
1 study · 60 participants
Low

All diet and/or exercise interventions vs (Optimised) usual care

Pre‐eclampsia · pregnant women

All diet and/or exercise interventions showed no clear difference in pre‐eclampsia compared with standard/other care (high certainty).

1 finding from 1 review

Diet or exercise, or both, for preventing excessive weight gain in pregnancy 2015 · Cochrane Headline outcomes only
RR 0.95 [0.77, 1.16]
15 studies · 5330 participants
High

Universal screening vs No screening

Pre‐eclampsia · women during pregnancy

The review found no eligible studies for this question.

1 finding from 1 review

Screening and subsequent management for thyroid dysfunction pre‐pregnancy and during pregnancy for improving maternal… 2015 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Universal screening vs case finding

Pre‐eclampsia · women during pregnancy

Universal screening showed no clear difference in pre‐eclampsia compared with case finding (moderate certainty).

1 finding from 1 review

Screening and subsequent management for thyroid dysfunction pre‐pregnancy and during pregnancy for improving maternal… 2015 · Cochrane Headline outcomes only
RR 0.87 [0.64, 1.18]
1 study · 4516 participants
Moderate

Guided imagery vs quiet rest

Severe pre‐eclampsia · pregnant women (between 30 and 36 weeks’ gestation) with elevated blood pressure

The review found no eligible studies for this question.

1 finding from 1 review

Guided imagery for treating hypertension in pregnancy 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Any antihypertensive drug vs no antihypertensive drugs/placebo

Severe pre‐eclampsia · women with mild to moderate hypertension during pregnancy

It is very uncertain whether any antihypertensive drug changes severe pre‐eclampsia compared with no antihypertensive drugs/placebo (very low certainty).

1 finding from 1 review

Antihypertensive drug therapy for mild to moderate hypertension during pregnancy 2018 · Cochrane Headline outcomes only
RR 0.56 [0.15, 2.02]
3 studies · 416 participants
Very low

Intervention not reported

Clinical pre‐eclampsia · All pregnant women receiving either vitamin C supplementation or control either in areas where there is inadequate dietary intake or where…

The intervention showed no clear difference in clinical pre‐eclampsia (moderate certainty).

1 finding from 1 review

Vitamin C supplementation in pregnancy 2015 · Cochrane Headline outcomes only
RR 0.92 [0.8, 1.05]
16 studies · 21956 participants
Moderate

Intervention not reported

Proteinuric pre‐eclampsia · pregnant women considered to be at risk of developing pre‐eclampsia

The intervention leads to lower proteinuric pre‐eclampsia (high certainty).

1 finding from 1 review

Antiplatelet agents for preventing pre‐eclampsia and its complications 2019 · Cochrane Headline outcomes only
RR 0.82 [0.77, 0.88]
60 studies · 36716 participants
High

Any antihypertensive drug vs no antihypertensive drugs/placebo

Proteinuria/pre‐eclampsia · women with mild to moderate hypertension during pregnancy

Any antihypertensive drug showed no clear difference in proteinuria/pre‐eclampsia compared with no antihypertensive drugs/placebo (low certainty).

1 finding from 1 review

Antihypertensive drug therapy for mild to moderate hypertension during pregnancy 2018 · Cochrane Headline outcomes only
RR 0.92 [0.75, 1.14]
23 studies · 2851 participants
Low

Vitamin E vs placebo, no placebo or other supplements

Pre‐eclampsia · pregnant women receiving vitamin E supplementation or control, living in areas where there is either inadequate dietary intake of vitamin…

Any vitamin E supplementation showed no clear difference in clinical pre‐eclampsia (random‐effects model) compared with placebo, no placebo or other supplements (moderate certainty).

1 finding from 1 review

Vitamin E supplementation in pregnancy 2015 · Cochrane Headline outcomes only
RR 0.91 [0.79, 1.06]
14 studies · 20878 participants
Moderate

Metformin vs insulin

Hypertensive disorders of pregnancy: pre‐eclampsia · women with type 2 diabetes

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).

1 finding from 1 review

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)

Hypertensive disorders of pregnancy: pre‐eclampsia · pregnant women with GDM

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).

1 finding from 1 review

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

Hypertensive disorders of pregnancy: pre‐eclampsia · women with gestational diabetes mellitus

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

1 finding from 1 review

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

Probiotics vs placebo

Hypertensive disorders of pregnancy: pre‐eclampsia · preventing gestational diabetes

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

1 finding from 1 review

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

Hypertensive disorders of pregnancy: pre‐eclampsia · pregnant women

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

1 finding from 1 review

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

Hypertensive disorders of pregnancy: pre‐eclampsia · pregnant women, excluding women already diagnosed with GDM in this pregnancy and those with pre‐existing diabetes mellitus

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

1 finding from 1 review

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

Hypertensive disorders of pregnancy: pre‐eclampsia · women with gestational diabetes mellitus

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

1 finding from 1 review

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

Insulin vs anti‐diabetic agent

Hypertensive disorders of pregnancy: pre‐eclampsia · women with gestational diabetes mellitus

Insulin showed no clear difference in hypertensive disorders of pregnancy (pre‐eclampsia) compared with anti‐diabetic agent (moderate certainty).

1 finding from 1 review

Insulin for the treatment of women with gestational diabetes 2017 · Cochrane Headline outcomes only
RR 1.14 [0.86, 1.52]
10 studies · 2060 participants
Moderate