Cochrane · systematic review · CD012037
Insulin for the treatment of women with gestational diabetes
Brown, J, Grzeskowiak, L, Williamson, K, et al. · Cochrane Database of Systematic Reviews · 2017 · 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
17
current version
GRADE rated
14
No studies
3
Included studies
NR
No studies 3 · 17.6%Ungraded 0 · 0%Very low 1 · 5.9%Low 5 · 29.4%Moderate 8 · 47.1%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
Insulin compared to anti‐diabetic agent for the treatment of women with gestational diabetes (maternal outcomes)
Population: the treatment of women (maternal outcomes) with gestational diabetes
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hypertensive disorders of pregnancy (pre‐eclampsia) Insulin vs anti‐diabetic agent | RR 1.14 [0.86, 1.52] | 10 studies · 2060 participants | Moderate Downgraded: risk of bias |
Hypertensive disorders of pregnancy (not defined) Insulin vs anti‐diabetic agent | RR 1.89 [1.14, 3.12] | 4 studies · 1214 participants | Moderate Downgraded: risk of bias |
Caesarean section Insulin vs anti‐diabetic agent | RR 1.03 [0.93, 1.14] | 17 studies · 1988 participants | Moderate Downgraded: risk of bias |
Development of type 2 diabetes Insulin vs anti‐diabetic agent | RR 1.39 [0.8, 2.44] | 2 studies · 754 participants | Moderate Downgraded: risk of bias, imprecision |
Perineal trauma/tearing ‐ not measured Insulin vs anti‐diabetic agent | no estimate extracted | NR | No studies |
Postnatal weight retention or return to pre‐pregnancy weight ‐ Maternal weight six to eight weeks postpartum ‐ Maternal weight one year postpartum Insulin vs anti‐diabetic agent | MD 1.6 | 1 study · 167 participants | Low Downgraded: risk of bias, imprecision |
Postnatal depression ‐ not reported Insulin vs anti‐diabetic agent | no estimate extracted | NR | No studies |
Induction of labour Insulin vs anti‐diabetic agent | RR 1.3 | 3 studies · 348 participants | Moderate Downgraded: risk of bias, imprecision |
Insulin compared to anti‐diabetic agent for the treatment of women with gestational diabetes (infant/child/adult outcomes)
Population: Infants of women with gestational diabetes.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Large‐for‐gestational age (birthweight > 90th centile) Insulin vs anti‐diabetic agent | RR 1.01 [0.76, 1.35] | 13 studies · 2352 participants | Moderate Downgraded: risk of bias |
Perinatal (fetal and neonatal death) and later infant mortality Insulin vs anti‐diabetic agent | RR 0.85 [0.29, 2.49] | 10 studies · 1463 participants | Low Downgraded: risk of bias |
Death or serious morbidity composite Insulin vs anti‐diabetic agent | RR 1.03 [0.84, 1.26] | 2 studies · 760 participants | Moderate Downgraded: risk of bias |
Neonatal hypoglycaemia Insulin vs anti‐diabetic agent | RR 1.14 [0.85, 1.52] | 24 studies · 3892 participants | Low Downgraded: risk of bias |
Adiposity at birth ‐ percentage fat mass Insulin vs anti‐diabetic agent | no estimate extracted | 1 study · 82 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Adiposity at birth ‐ skinfold sum (mm) Insulin vs anti‐diabetic agent | no estimate extracted | 1 study · 82 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Adiposity in childhood up to 2 years ‐ total fat mass (%) Insulin vs anti‐diabetic agent | MD 0.5 | 1 study · 318 participants | Low Downgraded: risk of bias |
Childhood/adulthood diabetes (type 1, type 2) ‐ not reported Insulin vs anti‐diabetic agent | no estimate extracted | NR | No studies |
Neurosensory disability in later childhood (18 months) Mild developmental delay Hearing impairment Visual impairment Insulin vs anti‐diabetic agent | RR 1.07 [0.33, 3.44] | 1 study · 93 participants | Low Downgraded: risk of bias, imprecision, inconsistency |