Gestational diabetes mellitus in women born small or premature:
Systematic review and meta-analysis
Abstract
Abstract Objective: Women born preterm or with low birthweight (LBW)
have an increased future risk of gestational diabetes mellitus (GDM);
however, a quantitative summary of evidence is lacking. Herein, we aimed
to investigate whether LBW, small for gestational age (SGA) status, or
preterm birth are factors associated with GDM risk; moreover, the
evidence quality was assessed. Data Sources: We searched databases such
as MEDLINE, Embase, and CINAHL and study registries including
ClinicalTrials.gov and ICTRP from launch until October 29, 2020. Methods
of Study Selection: Major electronic databases were searched from
inception to October 29, 2020. Observational studies that examined the
association between birth weight or gestational age and GDM were
eligible. We pooled the odds ratios and 95% confidence intervals using
the DerSimonian and Laird random-effects model. Tabulation, Integration,
and Results: Eighteen studies were included (N = 827,382). The
meta-analysis showed that being born preterm, with LBW, or with SGA
status increased the risk of GDM (pooled odds ratio = 1.84; 95%
confidence interval: 1.54 to 2.20; I2 = 78.3%; τ2 = 0.07). Given a GDM
prevalence of 2.0%, 10%, and 20%, the absolute risk differences were
1.6%, 7.0%, and 11.5%, respectively. The certainty of evidence was
low due to serious concerns of risk of bias and publication bias.
Conclusion: Women born prematurely, with LBW, or with SGA status may be
at an increased risk of GDM. However, whether this should be considered
in clinical decision-making depends on the prevalence of gestational
diabetes mellitus. Protocol registration: PROSPERO (CRD42020142004)