What do systematic reviews say?

Any antihypertensive drug vs no antihypertensive drugs/placebo

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

• 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

Any antihypertensive drug vs no antihypertensive drugs/placebo

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

• 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

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

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

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

Insulin vs anti‐diabetic agent

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

• 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

Exercise vs control

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

• Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes 2017 · Cochrane Headline outcomes only
  RR 0.31 [0.01, 7.09]
  2 studies · 48 participants
  Low

Primary care screening vs secondary care screening

Primary care screening showed no clear difference in hypertensive disorders of pregnancy: pre‐eclampsia toxemia 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 0.8 [0.36, 1.78]
  1 study · 690 participants
  Low

Reduced number of antenatal care visits/goal‐oriented vs standard antenatal care visits

Reduced number of antenatal care visits/goal‐oriented showed no clear difference in hypertensive disorders of pregnancy (including pre‐eclampsia) compared with standard antenatal care visits (low certainty).

• Alternative versus standard packages of antenatal care for low‐risk pregnancy 2015 · Cochrane Headline outcomes only
  RR 0.95 [0.8, 1.12]
  6 studies · 54108 participants
  Low

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: severe hypertension or… 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 1.02 [0.07, 15.86]
  1 study · 95 participants
  Very low

Probiotics vs placebo

Probiotic showed no clear difference in hypertensive disorders (including pre‐eclampsia, pregnancy‐induced… compared with placebo (low certainty).

• Probiotic treatment for women with gestational diabetes to improve maternal and infant health and well‐being 2020 · Cochrane Headline outcomes only
  RR 1.5 [0.64, 3.53]
  3 studies · 256 participants
  Low

Telemedicine vs usual care

It is very uncertain whether telemedicine changes hypertensive disorders of pregnancy including pre‐eclampsia,… compared with standard care (very low certainty).

• Different methods and settings for glucose monitoring for gestational diabetes during pregnancy 2017 · Cochrane Headline outcomes only
  RR 1.49 [0.69, 3.2]
  4 studies · 275 participants
  Very low

Continuous glucose monitoring system vs intermittent glucose monitoring

Continuous glucose monitoring may leads to lower hypertensive disorders of pregnancy (including pre‐eclampsia,… compared with intermittent glucose monitoring (low certainty).

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  RR 0.58 [0.39, 0.85]
  2 studies · 384 participants
  Low

Pre‐prandial vs post‐prandial glucose monitoring

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Automated telemedicine monitoring vs conventional

• Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes 2019 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported