February Cochrane review round up
medwireNews: The only diabetes-related Cochrane review published in February aimed to compare the effect of planned versus expectant births on health outcomes among pregnant women with pre-existing diabetes and their infants, but found no relevant trials to review.
The review was carried out as an update to “Elective delivery in diabetic pregnant women,” published by the Cochrane Library in 2001, which included “diabetic pregnant women” but did not distinguish between pre-existing and gestational diabetes.
However, Linda Biesty, from the National University of Ireland Galway, and colleagues found no randomized or non-randomized trials comparing planned birth (either by induction of labour or cesarean birth) at or near term gestation (37 to 40 weeks’ gestation) with an expectant approach in women with pre-existing diabetes.
This is despite current clinical guidelines supporting elective birth, at or near term, due to an increased risk for perinatal mortality during the third trimester of pregnancy in this group of women.
“In the absence of evidence, we are unable to reach any conclusions,” Biesty and co-authors write.
They therefore conclude that their review highlights “the urgent need for high-quality trials evaluating the effectiveness of planned birth at or near term gestation for pregnant women with pre-existing (Type 1 or Type 2) diabetes compared with an expectant approach.”
Biesty and team published a separate Cochrane review of the data for women with gestational diabetes in January 2018.
By Laura Cowen
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