Summary of findings 1. Probiotic compared to placebo for treating women with gestational diabetes for improving maternal and infant health and well‐being ‐ maternal outcomes.
| Probiotic compared to placebo for treating women with gestational diabetes for improving maternal and fetal health and well‐being ‐ maternal outcomes | |||||
| Patient or population: pregnant women diagnosed with gestational diabetes Setting: Iran (8), Ireland (1), Thailand (1) Intervention: probiotics (any type) administered by any route given during pregnancy to treat women with gestational diabetes Comparison: placebo (similar appearance and taste to the probiotics) or standard care | |||||
| Outcomes | № of participants (studies) Follow up | Certainty of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects* (95% CI) | |
| Risk with placebo | Risk difference with probiotic | ||||
| Hypertensive disorders (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) | 256 (3 RCTs) | ⊕⊕⊝⊝ LOW 1 | RR 1.50 (0.64 to 3.53) | Study population | |
| 63 per 1000 | 26 more per 1000 (26 fewer to 151 more) | ||||
| Subsequent development of type 2 diabetes | (0 studies) | not estimable | No outcome data reported in the included studies. | ||
| Mode of birth (caesarean) | 267 (3 RCTs) | ⊕⊕⊝⊝ LOW 2 3 | RR 0.64 (0.30 to 1.35) | Study population | |
| 351 per 1000 | 224 fewer per 1000 (105 fewer to 474 more) | ||||
| Induction of labour | 127 (1 RCT) | ⊕⊝⊝⊝ VERY LOW 4 | RR 1.33 (0.74 to 2.37) | Study population | |
| 231 per 1000 | 76 more per 1000 (60 fewer to 316 more) | ||||
| Perineal trauma | (0 studies) | not estimable | No outcome data reported in the included studies. | ||
| Postnatal weight retention or return to pre‐pregnancy weight | (0 studies) | not estimable | No outcome data reported in the included studies. | ||
| Postnatal depression | (0 studies) | not estimable | No outcome data reported in the included studies. | ||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio. | |||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | |||||
1 Downgraded two levels due to serious concerns related to imprecision as only has 3 small studies with wide confidence intervals.
2 Downgraded one level due to serious concerns related to imprecision as only has 3 small studies with wide confidence intervals.
3 Downgraded one level due to serious concerns related to inconsistency as I2 of 69%, studies showed different findings.
4 Downgraded two levels due to serious concerns related to imprecision as only one small study with wide confidence intervals. We downgraded for indirectness as the population of one study will not reflect population of all women with GDM.