Diabetes, Metabolic Syndrome and Obesity (Jun 2019)

Prognostic factors for cesarean section outcome of pregnant women with gestational diabetes mellitus: a systematic review and meta-analysis

  • Wang J,
  • Chen K,
  • Jin X,
  • Li X,
  • An P,
  • Yang N,
  • Chen Y,
  • Fang Y,
  • Mu Y

Journal volume & issue
Vol. Volume 12
pp. 913 – 929

Abstract

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Jinjing Wang,1,2,* Kang Chen,1,* Xinye Jin,1 Xueqiong Li,3 Ping An,1 Nan Yang,4 Yaolong Chen,4 Yi Fang,2 Yiming Mu11Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, People’s Republic of China; 2Department of Endocrinology, Fifth Medical Center of PLA General Hospital, Beijing 100071, People’s Republic of China; 3Department of Gerontology, First Affiliated Hospital of Kunming Medical University, Kunming 650031, People’s Republic of China; 4Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People’s Republic of China*These authors contributed equally to this work Objective: To evaluate the prognostic factors for cesarean section outcome of pregnant women with diabetes mellitus.Methods: MEDLINE, EMBASE, Cochrane Library, CBM, CNKI and Wanfang database were searched. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of included studies. For pooled data with factors of perioperative outcome, the RevMan software was used for data translation and meta-analysis. The result is shown intuitively with the bubble diagram of evidence mapping by Excel 2016.Results: We included 12 randomized controlled trials (RCTs) in the meta-analysis. Twelve RCTs with 1,390 patients were included in the systematic review. The results show that the perioperative blood glucose management regimens, preoperative fasting and water deprivation, anesthesia regimens, postoperative fluid regimens, postoperative analgesia regimens, postoperative wound care regimens, psychological interventions, different dosing regimens for antibiotics, and obesity may affect the cesarean section outcome of diabetic mothers and newborns. The evidence for all the outcomes was low quality.Conclusion: Many prognostic factors have shown significant association with postoperative outcomes of cesarean section. More clinical research evidence with high-quality is needed.Keywords: gestational diabetes mellitus, caesarean section, prognostic factors, systematic review, meta-analysis, evidence mapping

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