Evidence map›Paper›PMID 37973902›Full record

SynthesisNutrition & diabetes2023

Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus-a systematic review and meta-analysis of 257,876 pregnancies.

Swetha Sampathkumar, Durga Parkhi, Yonas Ghebremichael-Weldeselassie, Nithya Sukumar, Ponnusamy Saravanan

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Nutrition & diabetes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. [Management of hyperglycemia in pregnancy (Update 2026)].Wiener klinische Wochenschrift · 2026
    Review
  5. Article
  6. Review
  7. Article
  8. Review
  9. Diabetes and women's health.Journal of diabetes investigation · 2025
    Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Swetha SampathkumarDivision of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK.ORCID 0000-0001-6820-9183
Durga ParkhiDivision of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK.
Yonas Ghebremichael-WeldeselassieDivision of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK.
Nithya SukumarDivision of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK.
Ponnusamy SaravananDivision of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK. p.saravanan@warwick.ac.uk.
George Eliot Hospital · GBUniversity of Warwick · GBThe Open University · GB

Funding

Medical Research Council MR/N006232/1
6 · The paper itself

Abstract

backgroundGestational Diabetes Mellitus (GDM) is hyperglycaemia first detected during pregnancy. Globally, GDM affects around 1 in 6 live births (up to 1 in 4 in low- and middle-income countries- LMICs), thus, urgent measures are needed to prevent this public health threat.

objectiveTo determine the effectiveness of pre-pregnancy lifestyle in preventing GDM.

methodsWe searched MEDLINE, Web of science, Embase and Cochrane central register of controlled trials. Randomized control trials (RCTs), case-control studies, and cohort studies that assessed the effect of pre-pregnancy lifestyle (diet and/or physical activity based) in preventing GDM were included. Random effects model was used to calculate odds ratio (OR) with 95% confidence interval. The Cochrane ROB-2 and the Newcastle-Ottawa Scale were used for assessing the risk of bias. The protocol was registered in PROSPERO (ID: CRD42020189574)

resultsDatabase search identified 7935 studies, of which 30 studies with 257,876 pregnancies were included. Meta-analysis of the RCTs (N = 5; n = 2471) in women who received pre-pregnancy lifestyle intervention showed non-significant reduction of the risk of developing GDM (OR 0.76, 95% CI: 0.50-1.17, p = 0.21). Meta-analysis of cohort studies showed that women who were physically active pre-pregnancy (N = 4; n = 23263), those who followed a low carbohydrate/low sugar diet (N = 4; n = 25739) and those women with higher quality diet scores were 29%, 14% and 28% less likely to develop GDM respectively (OR 0.71, 95% CI: 0.57, 0.88, p = 0.002, OR 0.86, 95% CI: 0.68, 1.09, p = 0.22 and OR 0.72, 95% CI 0.60-0.87, p = 0.0006).

conclusionThis study highlights that some components of pre-pregnancy lifestyle interventions/exposures such as diet/physical activity-based preparation/counseling, intake of vegetables, fruits, low carbohydrate/low sugar diet, higher quality diet scores and high physical activity can reduce the risk of developing gestational diabetes. Evidence from RCTs globally and the number of studies in LMICs are limited, highlighting the need for carefully designed RCTs that combine the different aspects of the lifestyle and are personalized to achieve better clinical and cost effectiveness.

Indexed as

Diabetes, GestationalCarbohydratesDiet, Carbohydrate-RestrictedFemaleHumansLife StylePregnancySugarsCarbohydratesSugars

Identifiers

PMID37973902
PMCPMC10654718
OpenAlexW4388723236

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.