What do systematic reviews say?

Human insulin vs animal insulin (Different insulin types within similar insulin regimens)

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Insulin injected with a Novolin pen vs insulin injected with a needle or syringe (Different insulin regimens with similar insulin types used within the regimen)

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Lispro vs regular insulin (Different insulin types within similar insulin regimens)

It is very uncertain whether lispro changes pre‐eclampsia compared with regular insulin (Different insulin types within similar insulin… (very low certainty).

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  RR 0.68 [0.35, 1.3]
  1 study · 33 participants
  Very low

Insulin Aspart (+ NPH) vs human insulin (+ NPH insulin)

The review found no eligible studies for this question.

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Insulin Detemir + prandial insulin Aspart vs NPH insulin + prandial insulin Aspart (Different insulin types within similar insulin regimens)

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

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

Exercise vs control

• Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes 2017 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 254 participants
  High

CSII vs MDI: maternal outcomes

• Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

CSII vs MDI: maternal outcomes

• Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes 2016 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

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

The review found no eligible studies for this question.

• 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)

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

• 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)

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

• 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

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

Pyridoxine vs control

Pyridoxine (B6) showed no clear difference in pre‐eclampsia ‐ Antenatal oral pyridoxine versus control compared with control (low certainty).

• Pyridoxine (vitamin B6) supplementation during pregnancy or labour for maternal and neonatal outcomes 2015 · Cochrane Headline outcomes only
  RR 1.71 [0.85, 3.45]
  2 studies · 1197 participants
  Low
• Pyridoxine (vitamin B6) supplementation during pregnancy or labour for maternal and neonatal outcomes 2015 · Cochrane Headline outcomes only
  RR 1.43 [0.64, 3.22]
  1 study · 944 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

Vitamin E vs placebo, no placebo or other supplements

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).

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

Intervention not reported

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

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

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

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

• 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

The review found no eligible studies for this question.

• 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

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

• 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