Behnam Susann, Arabin Birgit
Clara Angela Foundation Witten und Berlin, Witten, Germany.
Philipps University Marburg, Marburg, Germany.
Geburtshilfe Frauenheilkd. 2024 Jun 13;84(6):564-572. doi: 10.1055/a-2295-1725. eCollection 2024 Jun.
Health professionals and their patients should understand the importance of evidence. In the case of gestational diabetes mellitus, which is often associated with an abnormally high body mass index, the immediate and long-term outcome of women and their offspring depends in part on advice and implementation of lifestyle changes before, during and after pregnancy.
Up to September 2023, MEDLINE, CENTRAL, and WEB OF SCIENCE were used to identify systematic reviews and meta-analyses on the prevention of gestational diabetes. The ROBIS and AMSTAR criteria were analyzed for all systematic reviews.
A total of 36 systematic reviews were identified. Dietary interventions, physical activity or a combined approach all reduced adverse pregnancy outcomes such as gestational diabetes, pregnancy-induced hypertension and related morbidities. Within the randomized controlled trials included in the 36 systematic reviews, the type, intensity and frequency of interventions varied widely. The primary outcomes, reporting and methodological quality of the 36 systematic reviews and meta-analyses also varied.The meta-analysis with the highest ROBIS and AMSTAR-2 scores was selected to design an icon array based on a fact box simulating 100 patients.
We propose a methodology for selecting the best evidence and transforming it into a format that illustrates the benefits and harms in a way that can be understood by lay patients, even if they cannot read. This model can be applied to counselling for expectant mothers in low and high-income countries, regardless of socioeconomic status, provided that women have access to appropriately trained healthcare providers.
卫生专业人员及其患者应了解证据的重要性。在通常与异常高体重指数相关的妊娠期糖尿病病例中,女性及其后代的近期和长期结局部分取决于孕期前后生活方式改变的建议及实施情况。
截至2023年9月,使用MEDLINE、CENTRAL和科学网检索关于预防妊娠期糖尿病的系统评价和荟萃分析。对所有系统评价分析ROBIS和AMSTAR标准。
共识别出36项系统评价。饮食干预、体育活动或综合方法均能降低不良妊娠结局,如妊娠期糖尿病、妊娠高血压及相关疾病。在这36项系统评价纳入的随机对照试验中,干预的类型、强度和频率差异很大。这36项系统评价和荟萃分析的主要结局、报告情况和方法学质量也各不相同。选择ROBIS和AMSTAR - 2评分最高的荟萃分析,基于一个模拟100名患者的情况说明书设计图标阵列。
我们提出一种方法,用于选择最佳证据并将其转化为一种格式,以一种即使非专业患者无法阅读也能理解的方式说明益处和危害。该模型可应用于低收入和高收入国家的准妈妈咨询,无论社会经济地位如何,前提是女性能够获得经过适当培训的医疗保健提供者的服务。