Comment: The quality of evidence is downgraded by study limitations (unclear sequence generation and allocation concealment) and by imprecise results (small trials only), and upgraded by large magnitude of effect.
Use dietary counselling and metabolic monitoring for women with pregnancy hyperglycaemia not meeting the criteria for gestational diabetes.A Cochrane review included 4 studies with a total of 543 women and their babies. Babies born to women receiving management (generally dietary counselling and metabolic monitoring) for borderline GDM (diagnosed by oral glucose tolerance test) were less likely to be macrosomic (birthweight greater than 4000 g) (RR 0.38, 95% CI 0.19 to 0.74; 3 trials, 438 infants) or large-for-gestational age (LGA) (RR 0.37, 95% CI 0.20 to 0.66; 3 trials, 438 infants) when compared with those in the routine care group. There were no significant differences in rates of caesarean section (RR 0.93, 95% CI 0.68 to 1.27; 3 trials, n=509) and operative vaginal birth (RR 1.37, 95% CI 0.20 to 9.27; 1 trial, n=83) between the two groups.
Date of latest search: 21 November 2011