What do systematic reviews say?

75 g OGTT vs 100 g OGTT

• Different strategies for diagnosing gestational diabetes to improve maternal and infant health 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)

• 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

Pre‐mixed insulin (70 NPH/30 REG) vs self‐mixed split dose insulin (Different insulin regimens with similar insulin types used within the regimen)

It is very uncertain whether pre‐mixed insulin (70 NPH/30 REG) changes macrosomia compared with self‐mixed split dose insulin (Different insulin regimens with… (very low certainty).

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  RR 0.49 [0.09, 2.54]
  1 study · 93 participants
  Very low

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)

It is very uncertain whether insulin injected with a Novolin pen changes macrosomia compared with insulin injected with a needle or syringe (Different insulin… (very low certainty).

• Different insulin types and regimens for pregnant women with pre‐existing diabetes 2017 · Cochrane Headline outcomes only
  RR 0.21 [0.03, 1.76]
  1 study · 93 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

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

It is very uncertain whether human insulin changes macrosomia compared with animal 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 0.22 [0.01, 4.3]
  1 study · 42 participants
  Very low

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

All diet and/or exercise interventions showed no clear difference in macrosomia Infant birthweight > 4000 g 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 0.93 [0.86, 1.02]
  27 studies · 8598 participants
  High

Labour induction vs expectant management

Induction of labour showed no clear difference in caesarean section compared with expectant management (moderate certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 0.91 [0.76, 1.09]
  4 studies · 1190 participants
  Moderate

Labour induction vs expectant management

Induction of labour showed no clear difference in instrumental delivery compared with expectant management (low certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 0.86 [0.65, 1.13]
  4 studies · 1190 participants
  Low

Labour induction vs expectant management

Induction of labour probably leads to lower shoulder dystocia compared with expectant management (moderate certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 0.6 [0.37, 0.98]
  4 studies · 1190 participants
  Moderate

Labour induction vs expectant management

Induction of labour showed no clear difference in brachial plexus injury compared with expectant management (low certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 0.21 [0.01, 4.28]
  4 studies · 1190 participants
  Low

Labour induction vs expectant management

Induction of labour leads to lower fracture (any) compared with expectant management (high certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 0.2 [0.05, 0.79]
  4 studies · 1190 participants
  High

Labour induction vs expectant management

Induction of labour showed no clear difference in low Apgar score (5 minutes) compared with expectant management (low certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 1.51 [0.25, 9.02]
  2 studies · 858 participants
  Low

Labour induction vs expectant management

Induction of labour showed no clear difference in low arterial cord blood pH (< 7.10) compared with expectant management (moderate certainty).

• Induction of labour at or near term for suspected fetal macrosomia 2023 · Cochrane Headline outcomes only
  RR 1.01 [0.46, 2.22]
  1 study · 818 participants
  Moderate