Cochrane · systematic review · CD009613
Techniques of monitoring blood glucose during pregnancy for women with pre‐existing diabetes
Jones, LV, Ray, A, Moy, FM, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
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
24
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 10 · 41.7%Very low 10 · 41.7%Low 3 · 12.5%Moderate 1 · 4.2%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
Current version onlyContinuous glucose monitoring compared to intermittent glucose monitoring for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) Continuous glucose monitoring vs intermittent glucose monitoring | RR 0.58 [0.39, 0.85] | 2 studies · 384 participants | Low Downgraded: risk of bias |
Caesarean section Continuous glucose monitoring vs intermittent glucose monitoring | RR 0.94 [0.75, 1.18] | 3 studies · 427 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Large‐for‐gestational age Continuous glucose monitoring vs intermittent glucose monitoring | RR 0.84 [0.57, 1.26] | 3 studies · 421 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Perinatal mortality (stillbirth and neonatal mortality) Continuous glucose monitoring vs intermittent glucose monitoring | RR 0.82 [0.05, 12.61] | 1 study · 71 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Self‐monitoring compared to a different type of self‐monitoring for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) Self‐monitoring vs a different type of self‐monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Self‐monitoring vs a different type of self‐monitoring | RR 0.78 [0.4, 1.49] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Large‐for‐gestational age Self‐monitoring vs a different type of self‐monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality (stillbirth and neonatal mortality) Self‐monitoring vs a different type of self‐monitoring | RR 3 [0.13, 67.91] | 1 study · 28 participants | Very low Downgraded: risk of bias |
Self‐monitoring at home compared to hospitalisation for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) Self‐monitoring at home vs hospitalisation | RR 1.19 [0.41, 3.51] | 1 study · 100 participants | Very low Downgraded: risk of bias |
Caesarean section Self‐monitoring at home vs hospitalisation | RR 0.96 [0.65, 1.44] | 1 study · 100 participants | Very low Downgraded: risk of bias |
Large‐for‐gestational age Self‐monitoring at home vs hospitalisation | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality (stillbirth and neonatal mortality) Self‐monitoring at home vs hospitalisation | RR 0.85 [0.05, 13.24] | 1 study · 100 participants | Very low Downgraded: risk of bias |
Pre‐prandial compared to post‐prandial glucose monitoring for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) Pre‐prandial vs post‐prandial glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Pre‐prandial vs post‐prandial glucose monitoring | RR 1.45 [0.92, 2.28] | 1 study · 61 participants | Very low Downgraded: risk of bias |
Large‐for‐gestational age Pre‐prandial vs post‐prandial glucose monitoring | RR 1.16 [0.73, 1.85] | 1 study · 61 participants | Very low Downgraded: risk of bias |
Perinatal mortality (stillbirth and neonatal mortality) Pre‐prandial vs post‐prandial glucose monitoring | RR 2.91 [0.12, 68.66] | 1 study · 61 participants | Very low Downgraded: risk of bias |
Automated telemedicine monitoring compared to conventional for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Automated telemedicine monitoring vs conventional | RR 0.96 [0.62, 1.48] | 1 study · 32 participants | Very low Downgraded: risk of bias |
Large‐for‐gestational age Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality (stillbirth and neonatal mortality) Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Constant CGM compared to Intermittent CGM for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Constant CGM vs Intermittent CGM | RR 0.77 [0.33, 1.79] | 1 study · 25 participants | Very low Downgraded: risk of bias |
Large‐for‐gestational age Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality (stillbirth and neonatal mortality) Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Self‐monitoring compared to standard care for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy: pre‐eclampsia Self‐monitoring vs standard care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Hypertensive disorders of pregnancy: gestational hypertension Self‐monitoring vs standard care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Self‐monitoring vs standard care | RR 0.78 [0.4, 1.49] | 1 study · 28 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: Maternal HbA1c (%) Self‐monitoring vs standard care | no estimate extracted | 1 study · 28 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: Maternal post‐prandial blood glucose (mmmol/L) Self‐monitoring vs standard care | no estimate extracted | 1 study · 13 participants | Very low Downgraded: imprecision |
Large‐for‐gestational age Self‐monitoring vs standard care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality Self‐monitoring vs standard care | RR 3 [0.13, 67.91] | 1 study · 28 participants | Very low Downgraded: imprecision |
Preterm birth less than 37 weeks' gestation Self‐monitoring vs standard care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Preterm birth less than 34 weeks' gestation Self‐monitoring vs standard care | no estimate extracted | 0 studies · 0 participants | Ungraded |
Self‐monitoring compared to hospitalisation for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy: pre‐eclampsia Self‐monitoring vs hospitalisation | RR 4.26 [0.52, 35.16] | 1 study · 100 participants | Very low Downgraded: imprecision |
Hypertensive disorders of pregnancy: hypertension in pregnancy Self‐monitoring vs hospitalisation | RR 0.43 [0.08, 2.22] | 1 study · 100 participants | Very low Downgraded: imprecision |
Caesarean section Self‐monitoring vs hospitalisation | RR 0.96 [0.65, 1.44] | 1 study · 100 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: maternal HbA1c Self‐monitoring vs hospitalisation | no estimate extracted | 0 studies · 0 participants | Ungraded |
Glycaemic control during/end of treatment: maternal post‐prandial blood glucose Self‐monitoring vs hospitalisation | no estimate extracted | 0 studies · 0 participants | Ungraded |
Large‐for‐gestational age Self‐monitoring vs hospitalisation | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality Self‐monitoring vs hospitalisation | RR 0.85 [0.05, 13.24] | 1 study · 100 participants | Very low Downgraded: imprecision |
Preterm birth less than 37 weeks' gestation Self‐monitoring vs hospitalisation | RR 0.85 [0.45, 1.6] | 1 study · 100 participants | Very low Downgraded: imprecision |
Preterm birth less than 34 weeks' gestation Self‐monitoring vs hospitalisation | no estimate extracted | 0 studies · 0 participants | Ungraded |
Pre‐prandial compared to post‐prandial glucose monitoring for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy: pre‐eclampsia Pre‐prandial vs post‐prandial glucose monitoring | RR 6.43 [0.82, 50.11] | 1 study · 58 participants | Very low Downgraded: imprecision |
Hypertensive disorders of pregnancy: gestational hypertension Pre‐prandial vs post‐prandial glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Pre‐prandial vs post‐prandial glucose monitoring | RR 1.45 [0.92, 2.28] | 1 study · 61 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: HbA1c (%) Pre‐prandial vs post‐prandial glucose monitoring | no estimate extracted | 1 study · 61 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: post‐prandial blood glucose Pre‐prandial vs post‐prandial glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Large‐for‐gestational age Pre‐prandial vs post‐prandial glucose monitoring | RR 1.16 [0.73, 1.85] | 1 study · 61 participants | Very low Downgraded: imprecision |
Perinatal mortality Pre‐prandial vs post‐prandial glucose monitoring | RR 2.91 [0.12, 68.66] | 1 study · 61 participants | Very low Downgraded: imprecision |
Preterm birth less than 37 weeks Pre‐prandial vs post‐prandial glucose monitoring | RR 1.33 [0.62, 2.84] | 1 study · 61 participants | Very low Downgraded: imprecision |
Preterm birth less than 34 weeks' gestation Pre‐prandial vs post‐prandial glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Automated telemedicine monitoring compared to conventional for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy: pre‐eclampsia, gestational hypertension Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Hypertensive disorders of pregnancy: gestational hypertension Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Automated telemedicine monitoring vs conventional | RR 0.96 [0.62, 1.48] | 1 study · 32 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: maternal HbA1c (%) Automated telemedicine monitoring vs conventional | no estimate extracted | 3 studies · 82 participants | Very low Downgraded: imprecision, inconsistency |
Glycaemic control during/end of treatment: maternal post‐prandial blood glucose (mmol/L) Automated telemedicine monitoring vs conventional | no estimate extracted | 2 studies · 50 participants | Very low Downgraded: imprecision, inconsistency |
Large‐for‐gestational age Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Preterm birth less than 37 weeks' gestation Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Preterm birth less than 34 weeks' gestation Automated telemedicine monitoring vs conventional | no estimate extracted | 0 studies · 0 participants | Ungraded |
Continuous glucose monitoring compared to intermittent glucose monitoring for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy: pre‐eclampsia Continuous glucose monitoring vs intermittent glucose monitoring | RR 1.37 [0.52, 3.59] | 2 studies · 225 participants | Low Downgraded: imprecision |
Hypertensive disorders of pregnancy: gestational hypertension Continuous glucose monitoring vs intermittent glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Continuous glucose monitoring vs intermittent glucose monitoring | RR 1 [0.65, 1.54] | 2 studies · 225 participants | Very low Downgraded: imprecision, inconsistency |
Glycaemic control during/end of treatment: maternal HbA1c (%) Continuous glucose monitoring vs intermittent glucose monitoring | no estimate extracted | 1 study · 71 participants | Moderate Downgraded: imprecision, inconsistency |
Glycaemic control during/end of treatment: post‐prandial blood glucose Continuous glucose monitoring vs intermittent glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Large‐for‐gestational age Continuous glucose monitoring vs intermittent glucose monitoring | RR 0.89 [0.41, 1.92] | 2 studies · 221 participants | Very low Downgraded: imprecision, inconsistency |
Perinatal mortality Continuous glucose monitoring vs intermittent glucose monitoring | RR 0.82 [0.05, 12.61] | 1 study · 71 participants | Low Downgraded: imprecision |
Preterm birth less than 37 weeks Continuous glucose monitoring vs intermittent glucose monitoring | RR 1.1 [0.63, 1.94] | 2 studies · 228 participants | Low Downgraded: imprecision |
Preterm birth less than 34 weeks' gestation Continuous glucose monitoring vs intermittent glucose monitoring | no estimate extracted | 0 studies · 0 participants | Ungraded |
Constant CGM compared to Intermittent CGM for women with pre‐existing diabetes
Population: women with pre‐existing diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy: pre‐eclampsia Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Hypertensive disorders of pregnancy: gestational hypertension Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Caesarean section Constant CGM vs Intermittent CGM | RR 0.77 [0.33, 1.79] | 1 study · 25 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: maternal HbA1c (3rd trimester) (%) Constant CGM vs Intermittent CGM | no estimate extracted | 1 study · 25 participants | Very low Downgraded: imprecision |
Glycaemic control during/end of treatment: maternal blood glucose (3rd trimester) (mmmol/L) Constant CGM vs Intermittent CGM | no estimate extracted | 1 study · 25 participants | Very low Downgraded: imprecision |
Large‐for‐gestational age Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal mortality Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |
Preterm birth less than 37 weeks' gestation Constant CGM vs Intermittent CGM | RR 1.08 [0.08, 15.46] | 1 study · 25 participants | Very low Downgraded: imprecision |
Preterm birth less than 34 weeks' gestation Constant CGM vs Intermittent CGM | no estimate extracted | 0 studies · 0 participants | Ungraded |