Effective Interventions in Preventing Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis

Overview

Journal Commun Med (Lond)

Publisher Nature Portfolio

Specialty General Medicine

Date 2024 Apr 20

PMID 38643248

Authors

Wubet Worku Takele

Kimberly K Vesco

Jami Josefson

Leanne M Redman

Wesley Hannah

Maxine P Bonham

Mingling Chen

Sian C Chivers

Andrea J Fawcett

Jessica A Grieger

Nahal Habibi

Gloria K W Leung

Kai Liu

Eskedar G Mekonnen

Maleesa Pathirana

Alejandra Quinteros

Rachael Taylor

Gebresilasea G Ukke

Shao J Zhou

Siew Lim

Affiliations

Soon will be listed here.

Abstract

Background: Lifestyle choices, metformin, and dietary supplements may prevent GDM, but the effect of intervention characteristics has not been identified. This review evaluated intervention characteristics to inform the implementation of GDM prevention interventions.

Methods: Ovid, MEDLINE/PubMed, and EMBASE databases were searched. The Template for Intervention Description and Replication (TIDieR) framework was used to examine intervention characteristics (who, what, when, where, and how). Subgroup analysis was performed by intervention characteristics.

Results: 116 studies involving 40,940 participants are included. Group-based physical activity interventions (RR 0.66; 95% CI 0.46, 0.95) reduce the incidence of GDM compared with individual or mixed (individual and group) delivery format (subgroup p-value = 0.04). Physical activity interventions delivered at healthcare facilities reduce the risk of GDM (RR 0.59; 95% CI 0.49, 0.72) compared with home-based interventions (subgroup p-value = 0.03). No other intervention characteristics impact the effectiveness of all other interventions.

Conclusions: Dietary, physical activity, diet plus physical activity, metformin, and myoinositol interventions reduce the incidence of GDM compared with control interventions. Group and healthcare facility-based physical activity interventions show better effectiveness in preventing GDM than individual and community-based interventions. Other intervention characteristics (e.g. utilization of e-health) don't impact the effectiveness of lifestyle interventions, and thus, interventions may require consideration of the local context.

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