Relationship Between Improvements in Glycemic Control and Risk of Pregnancy Complications in Patients With Diabetes Mellitus: Metaregression Analysis of Randomized Controlled Trials of Intensive Glucose Management
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Le résumé fourni par la source
Background: It remains unknown whether improvements in prognosis of pregnancy in patients with diabetes mellitus are dependent on glycemic control (GC). This metaregression analysis was aimed at exploring the relationships between the improvements in GC. Methods: Using Embase and MEDLINE (from Jan. 1, 1950, to Apr. 29, 2024), we searched for randomized controlled trials of intensive glucose management in pregnant women with gestational, pregestational, or overt diabetes mellitus, in which the blood glucose level using any GC indicator and the incidence of any adverse maternal and/or fetal outcome were compared between two groups with different intensities of glucose management. Relative risks (RRs) of individual adverse outcomes were regressed on the reductions in individual GC indicators. Results: We examined the dose–response relationship between reductions in four GC indicators (hemoglobin A1c (A1C), fasting plasma glucose (FPG), 2‐h postprandial glucose, and mean blood glucose) and 14 adverse pregnancy outcomes in 62 eligible trials. Reductions in FPG were associated with the reduced risk of 10/14 adverse outcomes, with the exceptions being cesarean section, small for gestational age, premature rupture of membranes, and congenital malformation. Reductions in A1C were strongly associated with the reduced risk of cesarean section ( r = 0.67, p < 0.001), indicating that the RR (95% confidence interval) for a 1% incremental decrease in A1C was 0.63 (0.49–0.80). Conclusions: Risk reductions in the majority of pregnancy complications in those with diabetes depend on the improvement of GC induced by intensive glucose management.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Relationship Between Improvements in Glycemic Control and Risk of Pregnancy Complications in Patients With Diabetes Mellitus: Metaregression Analysis of Randomized Controlled Trials of Intensive Glucose Management
- Date Crossref
- 01/01/2025
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Niigata University Department of Hematology pays non établi dans la noticeUniversité ou école supérieure
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Chiba Prefectural University of Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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University of Niigata Prefecture pays non établi dans la noticeUniversité ou école supérieure
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Tokushima Bunri University Department of Food and Nutrition pays non établi dans la noticeUniversité ou école supérieure
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University of Toyama Department of Complex Biosystem Research pays non établi dans la noticeUniversité ou école supérieure
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Kyoto University Department of Pharmacoepidemiology pays non établi dans la noticeUniversité ou école supérieure
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University of Tsukuba pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Health Care Science Department of Nutrition pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Human Life Studies Department of Health and Nutrition pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Medicine Department of Internal Medicine (Endocrinology and Metabolism) pays non établi dans la noticeUniversité ou école supérieure
Department of Hematology — Niigata University, Chiba Prefectural University of Health Sciences et University of Niigata Prefecture, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.