Ethnic differences in the effects of lifestyle interventions on adverse pregnancy outcomes among women with gestational diabetes mellitus: A systematic review and meta-analysis

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2024-09-29 DOI:10.1016/j.diabres.2024.111875

Yingjun Mu , Junyao Huang , Jie Yang , Hui Zuo , Matteo Monami , Nayla Cristina do Vale Moreira , Akhtar Hussain

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引用次数: 0

Abstract

Aims

Lifestyle interventions are widely used among women with gestational diabetes mellitus (GDM). This study aimed to assess the ethnic disparities in the effectiveness of lifestyle interventions on reducing adverse pregnancy outcomes, particularly macrosomia and neonatal hypoglycemia among women with GDM.

Methods

We systematically searched the PubMed/MEDLINE, Web of Science, and Cochrane Library databases from January 1, 2000, up to March 31, 2024, to identify randomized controlled trials (RCTs) examining the effects of lifestyle interventions in GDM patients. Subgroup analysis was performed to investigate heterogeneity across different ethnic groups (including Asians, Whites/Caucasians, Hispanics/ Latinos, and Unknown ethnicity). The random effects model was used to calculate the relative risk (RR) and 95% confidence interval (CI).

Results

After applying inclusion and exclusion criteria, twenty-one studies comprising 4567 participants were included. Lifestyle interventions significantly reduced the incidence of macrosomia ((RR = 0.54; 95 % CI: 0.42–0.70, P < 0.001), with consistent effects observed across racial groups. Conversely, lifestyle interventions were associated with a significant reduction in the risk of neonatal hypoglycemia only among Asians (RR = 0.56; 95 % CI: 0.38–0.84, P = 0.004), while no significant effects were observed in Whites/Caucasians or Hispanics/Latinos (all P > 0.05). Sensitivity analyses confirmed the robustness of the findings.

Conclusions

Regardless of ethnic background, this study emphasizes the significant benefits of lifestyle interventions in reducing the risk of macrosomia among women with GDM. However, lifestyle interventions seem to reduce the risk of neonatal hypoglycemia only among Asians, which warrants further studies.

查看原文本刊更多论文

生活方式干预对妊娠糖尿病妇女不良妊娠结局影响的种族差异：系统回顾和荟萃分析。

目的：生活方式干预在妊娠糖尿病（GDM）妇女中被广泛使用。本研究旨在评估生活方式干预对减少不良妊娠结局（尤其是妊娠糖尿病妇女中的巨大儿和新生儿低血糖）的有效性方面存在的种族差异：我们系统地检索了从 2000 年 1 月 1 日至 2024 年 3 月 31 日的 PubMed/MEDLINE、Web of Science 和 Cochrane Library 数据库，以确定研究生活方式干预对 GDM 患者影响的随机对照试验 (RCT)。为了研究不同种族群体（包括亚洲人、白人/高加索人、西班牙裔/拉丁裔和未知种族）之间的异质性，进行了分组分析。随机效应模型用于计算相对风险（RR）和95%置信区间（CI）：结果：采用纳入和排除标准后，共纳入了 21 项研究，4567 名参与者。生活方式干预大大降低了巨型畸形的发生率（RR = 0.54; 95 % CI: 0.42-0.70, P < 0.001），不同种族群体的效果一致。相反，生活方式干预仅在亚洲人中显著降低了新生儿低血糖风险（RR = 0.56; 95 % CI: 0.37-0.84, P = 0.004），而在白人/高加索人或西班牙裔/拉丁裔中未观察到显著影响（所有 P > 0.05）。敏感性分析证实了研究结果的稳健性：无论种族背景如何，本研究强调了生活方式干预在降低 GDM 女性巨型畸形风险方面的显著益处。然而，生活方式干预似乎只在亚洲人中降低了新生儿低血糖的风险，这值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.