Health care and risk of adverse pregnancy outcomes among diabetic women: an updated meta-analysis
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Diabetic women appear to have adverse pregnancy outcomes. Although there were two meta-analyzes that examined the association between health care and adverse pregnancy outcomes, their results were limited because they only included congenital anomaly and perinatal mortality, and they did not clarify the detailed situations of diabetes and health care. This meta-analysis aims to completely evaluate the effects of health care in improving adverse pregnancy outcomes among diabetic mothers.
CNKI, EMBASE, Web of Science, and PubMed databases were searched for eligible studies up to December 2017, without any restrictions. Relevant cohort studies characterizing the relationship between health care and adverse pregnancy outcomes were selected for inclusion in the meta-analysis. We also screened the reference list of relevant studies. The fixed-effect models or random-effect models were used to calculate the risk estimates. The potential sources of heterogeneity were explored by stratified and sensitivity analyzes.
Twenty-one studies with 6685 cases were included in our analysis. Health care was associated with significantly decreased risk of congenital anomaly (RR 0.237; 95% CI 0.166–0.338), perinatal death (RR 0.457; 95% CI 0.294–0.712), large for gestational age (LGA) (RR 0.794; 95% CI 0.640–0.986), and neonatal hypoglycemia (RR 0.672; 95% CI 0.486–0.929). Publication bias was not found in most results, with the exception of congenital anomaly and small for gestational age (SGA).
Health care is associated with decreased risk of congenital anomaly, perinatal death, LGA, neonatal hypoglycemia.
KeywordsAdverse outcomes Diabetes Health care Meta-analysis
We are grateful to everyone who helped us to complete this study successfully.
GX: data collection, data analysis, manuscript writing. ZZ: contributed to the conception. TL: data collection. LQ: data collection. XH: contributed analysis tools. WZ: revised the manuscript. YL: approved the final version.
This work was supported by a Grant from National Natural Science Foundation of China (no: 81773530).
Compliance with ethical standards
Conflict of interest
Author Guohong Xie declares that she has no conflict of interest. Author Zan Zheng declares that he has no conflict of interest. Author Taocheng Liu declares that he has no conflict of interest. Author Lulu Qing declares that she has no conflict of interest. Author Xiuqing Hong declares that she has no conflict of interest. Author Wenting Zha declares that she has no conflict of interest. Author Yuan Lv declares that she has no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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