Cochrane · systematic review · CD008540
Different intensities of glycaemic control for pregnant women with pre‐existing diabetes
Middleton, P, Crowther, CA, Simmonds, L · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
12
No studies
30
Included studies
NR
No studies 30 · 71.4%Ungraded 0 · 0%Very low 7 · 16.7%Low 5 · 11.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Very tight versus tight‐moderate glycaemic control (maternal outcomes)
Population: pregnant women with pre‐existing type 1 diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pre‐eclampsia Very tight vs tight‐moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Caesarean section Very tight vs tight‐moderate glycaemic control (maternal outcomes) | RR 0.92 [0.49, 1.73] | 1 study · 22 participants | Very low Downgraded: imprecision |
Perineal trauma Very tight vs tight‐moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Gestational weight gain Very tight vs tight‐moderate glycaemic control (maternal outcomes) | no estimate extracted | 1 study · 22 participants | Very low Downgraded: imprecision |
Postnatal depression Very tight vs tight‐moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Induction of labour Very tight vs tight‐moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Later development of cardiovascular disease Very tight vs tight‐moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Very tight versus tight‐moderate glycaemic control (infant outcomes)
Population: pregnant women with pre‐existing type 1 diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Perinatal mortality Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision |
Serious perinatal morbidity Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | 1 study · 22 participants | Low Downgraded: imprecision |
Neonatal hypoglycaemia Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood adiposity Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood diabetes Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood neurosensory disability Very tight vs tight‐moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Tight versus moderate glycaemic control (maternal outcomes)
Population: pregnant women with pre‐existing type 1 diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pre‐eclampsia Tight vs moderate glycaemic control (maternal outcomes) | RR 5.29 [0.23, 122.91] | 1 study · 45 participants | Very low Downgraded: imprecision |
Caesarean section Tight vs moderate glycaemic control (maternal outcomes) | RR 1.21 [0.22, 6.5] | 1 study · 45 participants | Very low Downgraded: imprecision |
Perineal trauma Tight vs moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Gestational weight gain Tight vs moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Postnatal depression Tight vs moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Induction of labour Tight vs moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Later development of cardiovascular disease Tight vs moderate glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Tight versus moderate glycaemic control (infant outcomes)
Population: pregnant women with pre‐existing type 1 diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age (birthweight > 90th centile) Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | 1 study · 45 participants | Very low Downgraded: imprecision |
Perinatal mortality Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | 1 study · 45 participants | Very low Downgraded: imprecision |
Serious perinatal morbidity Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Neonatal hypoglycaemia Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood adiposity Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood diabetes Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood neurosensory disability Tight vs moderate glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Tight‐moderate versus loose glycaemic control (maternal outcomes)
Population: pregnant women with pre‐existing type 1 diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pre‐eclampsia Tight‐moderate vs loose glycaemic control (maternal outcomes) | RR 0.11 [0.01, 0.99] | 1 study · 60 participants | Low Downgraded: imprecision |
Caesarean section Tight‐moderate vs loose glycaemic control (maternal outcomes) | RR 0.28 [0.1, 0.78] | 1 study · 60 participants | Low Downgraded: imprecision |
Perineal trauma Tight‐moderate vs loose glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Gestational weight gain Tight‐moderate vs loose glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Postnatal depression Tight‐moderate vs loose glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Induction of labour Tight‐moderate vs loose glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Later development of cardiovascular disease Tight‐moderate vs loose glycaemic control (maternal outcomes) | no estimate extracted | NR | No studies |
Tight‐moderate versus loose glycaemic control (infant outcomes)
Population: pregnant women with pre‐existing type 1 diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age (birthweight > 90th centile) Tight‐moderate vs loose glycaemic control (infant outcomes) | RR 0.01 [0, 0.2] | 1 study · 60 participants | Low Downgraded: imprecision |
Perinatal mortality Tight‐moderate vs loose glycaemic control (infant outcomes) | RR 0.07 [0, 1.37] | 1 study · 60 participants | Very low Downgraded: imprecision |
Serious perinatal morbidity Tight‐moderate vs loose glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Neonatal hypoglycaemia Tight‐moderate vs loose glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood adiposity Tight‐moderate vs loose glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood diabetes Tight‐moderate vs loose glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |
Childhood/adulthood neurosensory disability Tight‐moderate vs loose glycaemic control (infant outcomes) | no estimate extracted | NR | No studies |