Impact of gestational diabetes mellitus treatment on medium/long-term outcomes after pregnancy: A systematic review and meta-analysis
Por:
García-Patterson A., Balsells M., Solà I., Gich I., Corcoy R.
Publicada:
1 ene 2023
Ahead of Print:
1 nov 2022
Resumen:
Aim: We aimed to evaluate the effect of gestational diabetes mellitus (GDM) treatment on medium/long-term outcomes both the mother and offspring. Methods: We performed a systematic review on randomized clinical trials addressing specific treatment of women with GDM versus usual care and its impact on maternal and offspring outcomes at medium/long-term. MEDLINE, EMBASE and CENTRAL were searched from inception to 8 October 2021. Outcome variables: maternal (diabetes, metabolic syndrome, 12 secondary); offspring (diabetes, impaired fasting glucose, impaired glucose tolerance, high body mass index, 15 secondary). Risk of bias was assessed with Cochrane tool and aggregation performed with Revman 5.4. Results: We included five studies (1140 women, 767 offspring) with follow-up ranging 4–16 years after delivery. GDM treatment likely does not reduce risk of maternal diabetes (RR 1.00; [95% CI 0.82–1.23]) and may not reduce that of metabolic syndrome (RR 0.93; [95% CI 0.71–1.22]). We obtained very uncertain evidence that treatment may increase maternal HDL-cholesterol. Findings showed that GDM treatment may not have an impact on infants' outcomes (RRs 0.79; [95% CI 0.39–1.69] for impaired fasting glucose; RR 0.91; [95% CI 0.74–1.12] for body mass index >85th centile and 0.89; [95% CI 0.65–1.22] for body mass index >95th centile respectively). Conclusions: With current evidence is uncertain if specific treatment of women with GDM has an impact on medium/long-term metabolic outcomes either in the mother or in the offspring. These results add evidence to the recommendation of systematically reevaluating mother and offspring after delivery. Registration: OSF, DOI 10.17605/OSF.IO/KFN79. © 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
Filiaciones:
García-Patterson A.:
St Pau Biomed Res Inst IIB St Pau, Barcelona, Spain
Balsells M.:
Independent Investigator, Barcelona, Spain
Solà I.:
St Pau Biomed Res Inst IIB St Pau, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Iberoamer Cochrane Ctr, Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Gich I.:
St Pau Biomed Res Inst IIB St Pau, Barcelona, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Autonoma Barcelona, Dept Farmacol & Terapeut, Barcelona, Spain
Corcoy R.:
St Pau Biomed Res Inst IIB St Pau, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Serv Endocrinol & Nutr, C St Quinti 89, Barcelona 08041, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBER Bioingn Biomat & Nanotecnol CIBER BBN, Madrid, Spain
hybrid, All Open Access; Hybrid Gold
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