Pregnancy Outcomes in Women with Type 1 Diabetes Depending on the Different Modes of Insulin Therapy

Газизова, Г. Р.; Gaysina, Leylya; Валеева, Ф. В.; Абакумова, А. А.; Sharipova, Jelena

doi:10.1007/s12668-016-0371-1

Cited by 1 publication

(3 citation statements)

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“…19,21,30,34,38,39,43,45,46,48,49 The remaining 28 studies compared perinatal outcomes according to each insulin administration modality among 5518 pregnant persons (3282 [59.5%] MDI vs 2,236 [40.5%] CSII) with pregestational DM and were quantitatively synthesized in the meta-analysis. 8,18,20,[22][23][24][25][26][27][28][29][31][32][33][35][36][37][40][41][42]47,[50][51][52][53][54][55] For the primary maternal outcome, CSII therapy was associated with greater odds of CD (20 studies: 63.24% vs 56.49%, OR 1.33 [95% CI 1.15-1.54]; Figure 2), with no significant heterogeneity between studies (I 2 = 0.0%, P = .58). We confirmed the robustness of this positive association LGA, birthweight…”

Section: Meta-analysis and Synthesis Of Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Six prospective observational cohort studies (including two secondary analyses of randomized controlled trials evaluating CGM therapy) and 33 retrospective cohort studies published from 2010 to 2022 met inclusion criteria and were selected for the systematic review (Figure 1 and Table 1). 8,18-55 In aggregate, the 39 studies included in the systematic review included 7528 pregnancies.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Continuous Subcutaneous Infusion Versus Multiple Daily Injections of Insulin for Pregestational Diabetes in Pregnancy: A Systematic Review and Meta-Analysis

Fisher

Huang

DuBord

et al. 2023

J Diabetes Sci Technol

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Background: The use of continuous subcutaneous insulin infusion (CSII) therapy in pregnancies affected by pregestational diabetes mellitus (DM) has generated mixed outcome data worthy of further investigation. This systematic review and meta-analysis aims to evaluate clinical outcomes associated with CSII versus multiple daily injections (MDIs) in pregnant persons with pregestational DM. Methods: A predefined, systematic, librarian-assisted search of MEDLINE (PubMed), Embase, Cochrane Library, Scopus, ClinicalTrials.gov, and World Health Organization International Clinical Trial Registry Platform (published from 2010 to 2022) yielded 3003 studies describing pregnancy outcomes associated with CSII and/or MDI for pregestational DM. The primary exposure was mode of insulin administration, with cesarean delivery and neonatal hypoglycemia as the primary maternal and neonatal outcomes, respectively. Secondary outcomes included hypertensive disorders of pregnancy, first and third-trimester glycemic control, large-for-gestational age (LGA) neonate, preterm birth, neonatal intensive care unit admission, need for respiratory support, hyperbilirubinemia, 5-minute Apgar <7, shoulder dystocia, and perinatal mortality. We calculated pooled odds ratios (OR) with 95% confidence intervals (CI) using random-effects models. Results: Among 39 eligible studies, 39% of the 5518 pregnancies included were exposed to CSII. Odds of cesarean delivery were higher with CSII (20 studies: 63% vs 56%, odds ratio [OR] 1.3 [95% confidence interval (CI) 1.2-1.5]), but we did not identify a difference in the odds of neonatal hypoglycemia (23 studies: 31% vs 34%, OR 1.1 [95% CI 0.9-1.5]). Among secondary outcomes, only the odds of LGA (20 studies: 47% vs 38%, OR 1.4 [95% CI 1.2-1.6]) were higher in individuals using CSII versus MDI. Conclusions: Use of CSII (vs MDI) for pregestational DM in pregnancy is associated with higher odds of cesarean delivery and delivery of an LGA neonate. Further evaluation of how CSII use may influence neonatal size and delivery route is warranted.

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