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A randomized controlled trial of a web-based education intervention for women with gestational diabetes mellitus [with consumer summary]
Carolan-Olah M, Sayakhot P
Midwifery 2019 Jan;68:39-47
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study aimed to investigate changes in maternal body mass index (BMI), blood pressure and glycemic level and infant birthweight using an online educational program compared to standard clinic-based GDM education. DESIGN: A preliminary randomized controlled trial of the online intervention was conducted in Melbourne, Australia between 2014 and 2015. A total of 110 women were randomized to (1) the control group and received standard clinic-based GDM education; or (2) the intervention group and received standard care plus the web-based education program. Data were collected at two time points: baseline and 12 weeks postpartum. Infant birthweight was also recorded. Chi-squared test, independent t-test and paired t-test were used to compare outcomes. PARTICIPANTS: Pregnant women with newly diagnosed GDM, in the Western region of Melbourne, Australia. FINDINGS: Statistically significant differences were reported between intervention and control groups in maternal weight and glycemia post-intervention (p < 0.05). More women in the intervention group than in the control group reported weight loss post-intervention (90.4% versus 48.3%, p < 0.001), and were considered a healthy weight (BMI 18.5, 24.9kg/m2) at 12 weeks postpartum (44.2% versus 31%). More women in the intervention group had attended for follow up OGTT at 12 weeks postpartum (96.2% versus 70.7%, p < 0.001). Comparing measures pre- and post-intervention in the intervention group, maternal BMI was lower ((28.60 +/- 7.93) versus (29.60 +/- 8.32); p = 0.000), maternal systolic blood pressure was increased but within normal range ((108.19 +/- 11.80) versus (107.29 +/- 12.13); p = 0.001), and maternal glycemic level returned to within normal limits ((4.86 +/- 0.42) versus (8.80 +/- 2.50); p = 0.026). Most women in both groups gave birth to normal birthweight infants (92.3% and 94.8%). These findings are offset by differences in the groups at baseline. KEY CONCLUSIONS: Findings suggest that the education intervention had a positive impact on women's postpartum weight and attendance at OGTT by 12 weeks postpartum. No effect was found on maternal blood pressure or infant birthweight. Further studies with matched intervention and control groups are needed to achieve more definitive conclusions.

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