Summary of findings 2. Myo‐inositol for preventing gestational diabetes: infant, child and adult outcomes.
| Antenatal supplementation with myo‐inositol for preventing gestational diabetes | ||||||
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Patient or population: infants of pregnant women Setting: hospital Intervention: myo‐inositol Comparison: folic acid or placebo | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with control | Risk with myo‐inositol | |||||
| Large‐for‐gestational age | Study population | RR 1.40 (0.65 to 3.02) | 234 (1 RCT) | ⊕⊕⊝⊝ Lowa,b | ||
| 85 per 1000 | 120 per 1000 (56 to 258) |
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| Perinatal mortality (stillbirth and neonatal mortality) | See comments | Not estimable | (0 studies) | No data reported this outcome in any of the included studies | ||
| Composite of serious neonatal outcomes | See comments | not estimable | (0 studies) | No data reported this outcome in any of the included studies | ||
| Neonatal hypoglycaemia | Study population | RR 3.07 (0.90 to 10.52) | 671 (4 RCTs) | ⊕⊝⊝⊝ Very lowc,d,e | ||
| 9 per 1,000 | 27 per 1000 (8 to 91) | |||||
| Adiposity | See comments | not estimable | (0 studies) | No data reported this outcome in any of the included studies | ||
| Diabetes | See comments | not estimable | (0 studies) | No data reported this outcome in any of the included studies | ||
| Neurosensory disability | See comments | not estimable | (0 studies) | No data reported this outcome in any of 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 | ||||||
a. Downgraded (‐1) for serious limitations in study design: the study was at high risk of performance bias and detection bias for lack of blinding.
b. Downgraded (‐1) for serious indirectness: only one study conducted in Ireland reported this outcome.
c. Downgraded (‐1) for serious limitations in study design: all studies were at high risk of performance bias; one study was at high risk of detection bias.
d. Downgraded (‐1) for serious indirectness: only one of the included studies was conducted outside Italy, and the Italian studies only included Caucasian women. Thus, the generalisability of findings is limited.
e. Downgraded (‐1) for serious imprecision: evidence of imprecision with wide confidence intervals crossing the line of no effect.