Department of Obstetrics, Zaozhuang Maternity and Child Health Care Hospital, Zaozhuang, Shandong, P.R. China.
Medicine (Baltimore). 2021 Apr 9;100(14):e25279. doi: 10.1097/MD.0000000000025279.
Gestational diabetes mellitus (GDM) affects 1% to 14% of pregnant women annually worldwide and is one of the most common pregnancy complications.
We reviewed studies on maternal and neonatal outcomes after dietary managements for women with GDM comparing caloric-restricted (intervention group) and unrestricted diets (control group).
We systematically searched online databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), ScienceDirect, and Google Scholar from inception until September 2019. We performed a meta-analysis with random-effects model and reported pooled risk ratios (RRs) or pooled mean differences (MD) with 95% confidence intervals (CIs).
We analyzed data from 6 randomized controlled trials including 1300 participants, most of them with high bias risks. We found that the women in the intervention group achieved slightly better glycemic control (pooled MD, -0.72 mg/dL; 95% CI, -7.10 to 5.66 mg/dL) and overall pregnancy outcomes (except neonatal hypoglycemia) than the women in the control group.
An energy-restricted diet does not seem superior to the usual/standard GDM diet based on maternal or neonatal outcomes. But, clinical recommendations cannot be made as the evidence is inconclusive.
妊娠糖尿病（GDM）每年影响全球 1%至 14%的孕妇，是最常见的妊娠并发症之一。
我们回顾了比较热量限制饮食（干预组）和不限饮食（对照组）管理 GDM 孕妇的母婴结局的研究。
我们系统地检索了在线数据库，包括 Medline、Cochrane 对照试验注册中心（CENTRAL）、ScienceDirect 和 Google Scholar，检索时间从建库至 2019 年 9 月。我们采用随机效应模型进行荟萃分析，并报告汇总风险比（RR）或汇总均数差值（MD）及其 95%置信区间（CI）。
我们分析了 6 项随机对照试验的数据，共纳入 1300 名参与者，其中大多数研究存在较高的偏倚风险。我们发现，与对照组相比，干预组的孕妇血糖控制略有改善（汇总 MD，-0.72mg/dL；95%CI，-7.10 至 5.66mg/dL），且总体妊娠结局（新生儿低血糖除外）也有所改善。
基于母婴结局，能量限制饮食似乎并不优于 GDM 的常规/标准饮食。但是，由于证据不确定，不能提出临床建议。
