Risk factors and interventions related to maternal and pre-pregnancy obesity, pre-diabetes and diabetes for maternal, fetal and neonatal outcomes: a systematic review

Around the world, 60 million women of reproductive age have type 2 diabetes and 15% of the pregnant women have gestational diabetes mellitus (GDM). GDM accounts for 90% of all cases of diabetes in pregnancy, and if left unrecognized pose a higher risk of morbidity for mother and the fetus. Although GDM is a temporary phenomenon for the pregnant woman, but 5–10% of women with GDM develop type 2 diabetes after delivery and more than 50% within 5–10 years of delivery. However, the prevalence critically depends on the diagnostic methods and criteria. This review has undertaken an in-depth analysis to systematically assess the risk factors and interventions for screening, detection, prevention and management of pre-pregnancy obesity, pre-diabetes and diabetes at different levels of care (community, outreach, facility) and to draw research gaps and recommendations particularly for low- and middle-income countries.