Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis

Authors

Wubet Worku Takele, Monash University
Kimberly K. Vesco, Kaiser Permanente Center for Health Research
Jami Josefson, Northwestern University
Leanne M. Redman, Pennington Biomedical Research Center
Wesley Hannah, Madras Diabetes Research Foundation
Wesley Hannah, Madras Diabetes Research Foundation
Maxine P. Bonham, Monash University
Mingling Chen, Monash University
Sian C. Chivers, King's College London
Andrea J. Fawcett, Children's Memorial Hospital
Andrea J. Fawcett, Children's Memorial Hospital
Jessica A. Grieger, Adelaide Medical School
Nahal Habibi, Adelaide Medical School
Gloria K.W. Leung, Monash University
Kai Liu, Monash University
Eskedar G. Mekonnen, Universiteit Antwerpen
Eskedar G. Mekonnen, Universiteit Antwerpen
Maleesa Pathirana, Adelaide Medical School
Alejandra Quinteros, Adelaide Medical School
Rachael Taylor, The University of Newcastle, Australia
Gebresilasea G. Ukke, Monash University
Gebresilasea G. Ukke, Monash University
Shao J. Zhou, The University of Adelaide
Paul W. Franks, Harvard T.H. Chan School of Public Health
Stephen S. Rich, University of Virginia School of Medicine
Robert Wagner, Deutsches Diabetes-Zentrum
Tina Vilsbøll, Steno Diabetes Center Copenhagen
Miriam S. Udler, Massachusetts General Hospital
Tiinamaija Tuomi, Helsinki University Hospital
Arianne Sweeting, Faculty of Medicine and Health
Emily K. Sims, Indiana University School of Medicine
Jennifer L. Sherr, Yale School of Medicine
Robert K. Semple, Edinburgh Medical School
Rebecca M. Reynolds, Edinburgh Medical School

Document Type

Article

Publication Date

12-1-2024

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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