Christos Chatzakis1, Dimitrios G Goulis2, Evangelia Mareti1, Makarios Eleftheriades3, Apostolos Zavlanos1, Konstantinos Dinas1, Alexandros Sotiriadis4. 1. 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece. 2. Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Ag. Pavlou 76, Thessaloniki, Greece. 3. 2(nd) Department of Obstetrics and Gynecology, Medical School, University of Athens, Aretaieio Hospital, Vas. Sofia 76, Athens, Greece. 4. 2(nd) Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Konstaninoupoleos 49, Thessaloniki, Greece. Electronic address: asotir@gmail.com.
Abstract
AIMS: Several interventions have been implemented to prevent the development of gestational diabetes mellitus (GDM) in obese pregnant women, including physical exercise programs, and administration of metformin, vitamin D and probiotics. The aim of this network meta-analysis was to compare the efficiency of these interventions and identify the optimal. MATERIALS: A network meta-analysis of randomized trials was performed comparing the different interventions for the development of GDM in overweight or obese women, either to each other or placebo/no intervention. A search was conducted in four electronic databases and grey literature sources. The primary outcome was the development of GDM; secondary outcomes were other complications of pregnancy. RESULTS: The meta-analysis included 23 studies (4237 participants). None of the interventions was superior compared with placebo/no intervention for the prevention of GDM. Metformin and physical exercise were superior to placebo/no intervention for gestational weight gain (MD -1.21, 95% CI -2.14 to -0.28 and MD -0.96, 95% CI -1.69 to -0.22, respectively). Metformin was superior to placebo/no intervention for caesarean sections and admission to NICU. CONCLUSIONS: Interventions aiming to prevent the development of GDM in overweight/obese women are not effective, when applied during pregnancy.
AIMS: Several interventions have been implemented to prevent the development of gestational diabetes mellitus (GDM) in obese pregnant women, including physical exercise programs, and administration of metformin, vitamin D and probiotics. The aim of this network meta-analysis was to compare the efficiency of these interventions and identify the optimal. MATERIALS: A network meta-analysis of randomized trials was performed comparing the different interventions for the development of GDM in overweight or obesewomen, either to each other or placebo/no intervention. A search was conducted in four electronic databases and grey literature sources. The primary outcome was the development of GDM; secondary outcomes were other complications of pregnancy. RESULTS: The meta-analysis included 23 studies (4237 participants). None of the interventions was superior compared with placebo/no intervention for the prevention of GDM. Metformin and physical exercise were superior to placebo/no intervention for gestational weight gain (MD -1.21, 95% CI -2.14 to -0.28 and MD -0.96, 95% CI -1.69 to -0.22, respectively). Metformin was superior to placebo/no intervention for caesarean sections and admission to NICU. CONCLUSIONS: Interventions aiming to prevent the development of GDM in overweight/obesewomen are not effective, when applied during pregnancy.
Authors: Sarah J Davidson; Helen L Barrett; Sarah A Price; Leonie K Callaway; Marloes Dekker Nitert Journal: Cochrane Database Syst Rev Date: 2021-04-19
Authors: Carlos Pascual-Morena; Iván Cavero-Redondo; Celia Álvarez-Bueno; José Alberto Martínez-Hortelano; Sara Reina-Gutiérrez; Alicia Saz-Lara; Sergio Núñez de Arenas-Arroyo; Vicente Martínez-Vizcaíno Journal: Front Med (Lausanne) Date: 2021-12-09
Authors: Louise Hayes; Catherine McParlin; Liane B Azevedo; Dan Jones; James Newham; Joan Olajide; Louise McCleman; Nicola Heslehurst Journal: Nutrients Date: 2021-03-23 Impact factor: 5.717