The effect of gestational diabetes mellitus on human milk macronutrients content

Maternal gestational diabetes and infant feeding, nutrition and growth: a systematic review and meta-analysis

“…Vohr et al (44) Low Uncertain Low Uncertain Uncertain Low Krishnaveni et al (45) Low High Low Uncertain Low Low Hummel et al (38) Uncertain High High Uncertain Low Low Crume et al (41) Low Low Uncertain Uncertain Uncertain Low Crume et al (42) Uncertain Low High Uncertain Uncertain High Finkelstein et al (59) Low Low High Uncertain Low Low Hummel et al (19) Low Low Uncertain Uncertain Low Low Konig et al (60) Uncertain High Low Uncertain Uncertain Low Kramer et al (46) Low High Low Uncertain Low Low Liu et al (55) Low Low Low Uncertain Low Low Uebel et al (54) Low Low Low Uncertain Uncertain Low Oza-Frank et al (56) Low Low Uncertain Uncertain Uncertain Low Chertok et al (47) Low High High Uncertain Uncertain Low Dritsakou et al (48) Uncertain High High Uncertain Uncertain Low Hakanen et al (43) Low High Uncertain Low Uncertain Low Logan et al (49) Low Low Low Uncertain Uncertain Low Oza-Frank et al (50) Low Low High Uncertain Uncertain Uncertain Zhao Pei et al (58) Low Uncertain Uncertain Uncertain Uncertain Low Zhao Y et al (37) Low Uncertain Uncertain Uncertain Uncertain Low Aris et al (51) Low Low Low Uncertain Uncertain Low Oza-Frank et al (57) Low Low Uncertain Uncertain Low Low Wallenborn et al (39) Low Uncertain High Uncertain Low Low Weisband et al (40) Low Low Uncertain Uncertain Uncertain Low Nguyen et al (52) Low Low Low Uncertain Uncertain Low Dugas et al (20) Low High Uncertain Uncertain Low Uncertain Shapira et al (53) Low High Low Uncertain Low Low…”

“…All the included studies were observational, with the majority being cohort studies; thirteen were prospective (19,37,(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) , eleven were retrospective (20,(38)(39)(40)(41)(42)(43)(55)(56)(57)(58)(59) and one was a retrospective casecontrol study (60) (Table 1). All but three studies (38,44,45) were published after 2010.…”

“…GDM was diagnosed using a one-step 2-h 75 g oral glucose tolerance test in six studies (37,43,51,52,54,60) ; one-step 3-h oral glucose tolerance test in one study (45) ; 50 g polycose screen followed by 2-h 75 g oral glucose tolerance test in two studies (49,55) and 3-h oral glucose tolerance test in four studies (41,42,44,46,53) ; or by maternal report in six studies (39,40,50,(56)(57)(58) . Diagnostic criteria for GDM were unclear in six studies (19,20,38,47,48,59) .…”

“…No study had low risk of bias for all domains ( Table 2). Only seven studies adjusted for potential confounding (19,39,40,50,52,54,59) and nine studies were at high risk of bias due to possible confounding (20,38,43,(45)(46)(47)(48)53,60) . Seven studies had high risk of bias relating to ascertainment of exposures (38,39,42,47,48,50,59) because exposures were not measured prior to outcomes of interest or were not well defined (38,47,48,59) .…”

“…Nutritional intake. Very low-quality evidence showed that mature breast milk of women with GDM compared with women without GDM did not differ in total energy content, lactose and fat content but had lower protein content (SMD −0•36, 95 % CI −0•68, −0•04; P = 0•03, I 2 = 0 %; two studies, 272 infants) (48,53) (Table 3; online Supplementary Fig. S7).…”