AIMS: Several interventions have been implemented to prevent the development of gestational diabetes mellitus (GDM) in obese pregnant women, including physical exercise programs, and administration of metformin, vitamin D and probiotics. The aim of this network meta-analysis was to compare the efficiency of these interventions and identify the optimal. MATERIALS: A network meta-analysis of randomized trials was performed comparing the different interventions for the development of GDM in overweight or obese women, either to each other or placebo or no intervention. A search was conducted in four electronic databases and grey literature sources. The primary outcome was the development of GDM; secondary outcomes were other complications of pregnancy. RESULTS: The meta-analysis included 23 studies (4,237 participants). None of the interventions was superior compared with placebo or no intervention for the prevention of GDM. Metformin and physical exercise were superior to placebo or no intervention for gestational weight gain (MD -1.21, 95% CI -2.14 to -0.28 and MD -0.96, 95% CI -1.69 to -0.22, respectively). Metformin was superior to placebo or no intervention for caesarean sections and admission to NICU. CONCLUSIONS: Interventions aiming to prevent the development of GDM in overweight/obese women are not effective, when applied during pregnancy.
With permission from Excerpta Medica Inc.

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