Scolaris Content Display Scolaris Content Display

Study flow diagram.
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Figure 1

Study flow diagram.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 1 Large‐for‐gestational age.
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Analysis 1.1

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 1 Large‐for‐gestational age.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 2 Hypertensive disorders of pregnancy (severe hypertension or pre‐eclampsia).
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Analysis 1.2

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 2 Hypertensive disorders of pregnancy (severe hypertension or pre‐eclampsia).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 3 Hypertensive disorders of pregnancy (eclampsia).
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Analysis 1.3

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 3 Hypertensive disorders of pregnancy (eclampsia).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 4 Caesarean section.
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Analysis 1.4

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 4 Caesarean section.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 5 Gestational age at birth (weeks).
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Analysis 1.5

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 5 Gestational age at birth (weeks).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 6 Preterm birth.
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Analysis 1.6

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 6 Preterm birth.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 7 Macrosomia.
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Analysis 1.7

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 7 Macrosomia.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 8 Small‐for‐gestational age.
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Analysis 1.8

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 8 Small‐for‐gestational age.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 9 Birthweight (g).
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Analysis 1.9

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 9 Birthweight (g).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 10 Head circumference at birth (cm).
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Analysis 1.10

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 10 Head circumference at birth (cm).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 11 Length at birth (cm).
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Analysis 1.11

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 11 Length at birth (cm).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 12 Ponderal index at birth (kg/m³).
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Analysis 1.12

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 12 Ponderal index at birth (kg/m³).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 13 Normal vaginal birth.
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Analysis 1.13

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 13 Normal vaginal birth.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 14 Operative vaginal birth.
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Analysis 1.14

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 14 Operative vaginal birth.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 15 Induction of labour.
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Analysis 1.15

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 15 Induction of labour.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 16 Postpartum haemorrhage.
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Analysis 1.16

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 16 Postpartum haemorrhage.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 17 Postpartum infection.
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Analysis 1.17

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 17 Postpartum infection.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 18 Gestational weight gain (kg).
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Analysis 1.18

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 18 Gestational weight gain (kg).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 19 Use of additional pharmacotherapy.
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Analysis 1.19

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 19 Use of additional pharmacotherapy.

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 20 Glycaemic control: end of intervention fasting plasma glucose (mmol/L).
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Analysis 1.20

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 20 Glycaemic control: end of intervention fasting plasma glucose (mmol/L).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 21 Glycaemic control: end of intervention 2‐hour postprandial glucose (mmol/L).
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Analysis 1.21

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 21 Glycaemic control: end of intervention 2‐hour postprandial glucose (mmol/L).

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 22 Glycaemic control: end of intervention HbA1c (%).
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Analysis 1.22

Comparison 1 Low‐moderate GI diet versus moderate‐high GI diet, Outcome 22 Glycaemic control: end of intervention HbA1c (%).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 1 Large‐for‐gestational age.
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Analysis 2.1

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 1 Large‐for‐gestational age.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 2 Perinatal mortality (stillbirth and neonatal mortality).
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Analysis 2.2

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 2 Perinatal mortality (stillbirth and neonatal mortality).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 3 Hypertensive disorders of pregnancy: pre‐eclampsia.
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Analysis 2.3

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 3 Hypertensive disorders of pregnancy: pre‐eclampsia.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 4 Caesarean section.
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Analysis 2.4

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 4 Caesarean section.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 5 Stillbirth.
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Analysis 2.5

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 5 Stillbirth.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 6 Neonatal mortality.
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Analysis 2.6

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 6 Neonatal mortality.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 7 Gestational age at birth (weeks).
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Analysis 2.7

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 7 Gestational age at birth (weeks).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 8 Macrosomia (> 4000 g).
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Analysis 2.8

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 8 Macrosomia (> 4000 g).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 9 Macrosomia (> 4500 g).
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Analysis 2.9

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 9 Macrosomia (> 4500 g).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 10 Birthweight (g).
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Analysis 2.10

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 10 Birthweight (g).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 11 Shoulder dystocia.
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Analysis 2.11

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 11 Shoulder dystocia.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 12 Bone fracture.
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Analysis 2.12

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 12 Bone fracture.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 13 Nerve palsy.
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Analysis 2.13

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 13 Nerve palsy.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 14 Neonatal hypoglycaemia.
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Analysis 2.14

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 14 Neonatal hypoglycaemia.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 15 Neonatal hyperbilirubinemia.
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Analysis 2.15

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 15 Neonatal hyperbilirubinemia.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 16 Neonatal hypocalcaemia.
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Analysis 2.16

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 16 Neonatal hypocalcaemia.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 17 Normal vaginal birth.
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Analysis 2.17

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 17 Normal vaginal birth.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 18 Operative vaginal birth.
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Analysis 2.18

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 18 Operative vaginal birth.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 19 Induction of labour.
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Analysis 2.19

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 19 Induction of labour.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 20 Gestational weight gain (kg).
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Analysis 2.20

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 20 Gestational weight gain (kg).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 21 Gestational weight gain: weight at birth (kg).
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Analysis 2.21

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 21 Gestational weight gain: weight at birth (kg).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 22 Insulin sensitivity: during intervention fasting plasma insulin (pM).
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Analysis 2.22

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 22 Insulin sensitivity: during intervention fasting plasma insulin (pM).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 23 Insulin sensitivity: end of intervention fasting plasma insulin (pM).
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Analysis 2.23

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 23 Insulin sensitivity: end of intervention fasting plasma insulin (pM).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 24 Use of additional pharmacotherapy.
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Analysis 2.24

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 24 Use of additional pharmacotherapy.

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 25 Glycaemic control: during intervention preprandial/fasting glucose (mmol/L).
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Analysis 2.25

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 25 Glycaemic control: during intervention preprandial/fasting glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 26 Glycaemic control: during intervention 24 hour mean plasma glucose (mmol/L).
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Analysis 2.26

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 26 Glycaemic control: during intervention 24 hour mean plasma glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 27 Glycaemic control: during intervention 1 hour postprandial glucose (mmol/L).
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Analysis 2.27

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 27 Glycaemic control: during intervention 1 hour postprandial glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 28 Glycaemic control: end of intervention preprandial/fasting glucose (mmol/L).
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Analysis 2.28

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 28 Glycaemic control: end of intervention preprandial/fasting glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 29 Glycaemic control: end of intervention 24‐hour mean plasma glucose (mmol/L).
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Analysis 2.29

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 29 Glycaemic control: end of intervention 24‐hour mean plasma glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 30 Glycaemic control: end of intervention 1‐hour postprandial glucose (mmol/L).
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Analysis 2.30

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 30 Glycaemic control: end of intervention 1‐hour postprandial glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 31 Glycaemic control: during/at end of intervention fasting glucose (mmol/L).
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Analysis 2.31

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 31 Glycaemic control: during/at end of intervention fasting glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 32 Glycaemic control: during/at end of intervention mean plasma glucose (mmol/L).
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Analysis 2.32

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 32 Glycaemic control: during/at end of intervention mean plasma glucose (mmol/L).

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 33 Glycaemic control: during/at end of intervention mean HbA1c (%).
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Analysis 2.33

Comparison 2 Energy‐restricted diet versus no energy‐restricted diet, Outcome 33 Glycaemic control: during/at end of intervention mean HbA1c (%).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 1 Hypertensive disorders of pregnancy: pre‐eclampsia.
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Analysis 3.1

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 1 Hypertensive disorders of pregnancy: pre‐eclampsia.

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 2 Caesarean section.
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Analysis 3.2

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 2 Caesarean section.

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 3 Gestational age at birth (weeks).
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Analysis 3.3

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 3 Gestational age at birth (weeks).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 4 Macrosomia (≥ 4000 g).
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Analysis 3.4

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 4 Macrosomia (≥ 4000 g).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 5 Birthweight (g).
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Analysis 3.5

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 5 Birthweight (g).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 6 Head circumference at birth (cm).
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Analysis 3.6

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 6 Head circumference at birth (cm).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 7 Length at birth(cm).
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Analysis 3.7

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 7 Length at birth(cm).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 8 Ponderal index at birth (kg/m³).
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Analysis 3.8

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 8 Ponderal index at birth (kg/m³).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 9 Placental abruption.
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Analysis 3.9

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 9 Placental abruption.

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 10 Gestational weight gain: BMI at end of intervention (kg/m²).
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Analysis 3.10

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 10 Gestational weight gain: BMI at end of intervention (kg/m²).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 11 Gestational weight gain: weight at end of intervention (kg).
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Analysis 3.11

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 11 Gestational weight gain: weight at end of intervention (kg).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 12 Insulin sensitivity: end of intervention HOMA‐IR.
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Analysis 3.12

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 12 Insulin sensitivity: end of intervention HOMA‐IR.

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 13 Insulin sensitivity: end of intervention insulin (µIU/mL).
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Analysis 3.13

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 13 Insulin sensitivity: end of intervention insulin (µIU/mL).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 14 Use of additional pharmacotherapy.
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Analysis 3.14

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 14 Use of additional pharmacotherapy.

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 15 Glycaemic control: end of intervention fasting blood glucose (mmol/L).
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Analysis 3.15

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 15 Glycaemic control: end of intervention fasting blood glucose (mmol/L).

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 16 Glycaemic control: at end of intervention HbA1c (%).
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Analysis 3.16

Comparison 3 DASH diet versus control diet with matching macronutrient contents, Outcome 16 Glycaemic control: at end of intervention HbA1c (%).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 1 Large‐for‐gestational age.
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Analysis 4.1

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 1 Large‐for‐gestational age.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 2 Perinatal mortality (stillbirth and neonatal mortality).
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Analysis 4.2

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 2 Perinatal mortality (stillbirth and neonatal mortality).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 3 Hypertensive disorders of pregnancy: maternal hypertension.
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Analysis 4.3

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 3 Hypertensive disorders of pregnancy: maternal hypertension.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 4 Caesarean section.
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Analysis 4.4

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 4 Caesarean section.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 5 Stillbirth.
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Analysis 4.5

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 5 Stillbirth.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 6 Gestational age at birth (weeks).
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Analysis 4.6

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 6 Gestational age at birth (weeks).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 7 Macrosomia (> 4000 g).
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Analysis 4.7

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 7 Macrosomia (> 4000 g).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 8 Small‐for‐gestational age.
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Analysis 4.8

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 8 Small‐for‐gestational age.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 9 Birthweight (g).
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Analysis 4.9

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 9 Birthweight (g).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 10 Neonatal hypoglycaemia.
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Analysis 4.10

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 10 Neonatal hypoglycaemia.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 11 Normal vaginal birth.
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Analysis 4.11

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 11 Normal vaginal birth.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 12 Operative vaginal birth.
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Analysis 4.12

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 12 Operative vaginal birth.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 13 Gestational weight gain: maternal weight gain (kg).
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Analysis 4.13

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 13 Gestational weight gain: maternal weight gain (kg).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 14 Adherence to dietary intervention: fully applied the recommended menu.
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Analysis 4.14

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 14 Adherence to dietary intervention: fully applied the recommended menu.

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 15 Use of additional pharmacotherapy..
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Analysis 4.15

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 15 Use of additional pharmacotherapy..

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 16 Glycaemic control: end of intervention fasting blood glucose (mg/dL).
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Analysis 4.16

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 16 Glycaemic control: end of intervention fasting blood glucose (mg/dL).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 17 Glycaemic control: end of intervention 2‐hour post breakfast blood glucose (mg/dL).
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Analysis 4.17

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 17 Glycaemic control: end of intervention 2‐hour post breakfast blood glucose (mg/dL).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 18 Glycaemic control: end of intervention 2‐hour post lunch blood glucose (mg/dL).
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Analysis 4.18

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 18 Glycaemic control: end of intervention 2‐hour post lunch blood glucose (mg/dL).

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 19 Glycaemic control: end of intervention 2‐hour post dinner blood glucose (mg/dL).
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Analysis 4.19

Comparison 4 Low‐carbohydrate diet versus high‐carbohydrate diet, Outcome 19 Glycaemic control: end of intervention 2‐hour post dinner blood glucose (mg/dL).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 1 Large‐for‐gestational age.
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Analysis 5.1

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 1 Large‐for‐gestational age.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 2 Hypertensive disorders of pregnancy: pre‐eclampsia.
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Analysis 5.2

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 2 Hypertensive disorders of pregnancy: pre‐eclampsia.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 3 Hypertensive disorders of pregnancy: hypertension in pregnancy.
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Analysis 5.3

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 3 Hypertensive disorders of pregnancy: hypertension in pregnancy.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 4 Caesarean section.
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Analysis 5.4

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 4 Caesarean section.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 5 Type 2 diabetes: 'diabetic' OGTT 1‐2 weeks postpartum.
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Analysis 5.5

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 5 Type 2 diabetes: 'diabetic' OGTT 1‐2 weeks postpartum.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 6 Type 2 diabetes: 'diabetic' OGTT 4‐13 months postpartum.
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Analysis 5.6

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 6 Type 2 diabetes: 'diabetic' OGTT 4‐13 months postpartum.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 7 Gestational age at birth (weeks).
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Analysis 5.7

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 7 Gestational age at birth (weeks).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 8 Preterm birth.
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Analysis 5.8

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 8 Preterm birth.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 9 Macrosomia (> 4000 g).
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Analysis 5.9

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 9 Macrosomia (> 4000 g).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 10 Birthweight (g).
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Analysis 5.10

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 10 Birthweight (g).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 11 Placental abruption.
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Analysis 5.11

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 11 Placental abruption.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 12 Gestational weight gain (kg).
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Analysis 5.12

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 12 Gestational weight gain (kg).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 13 Gestational weight gain: BMI at birth (kg/m²).
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Analysis 5.13

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 13 Gestational weight gain: BMI at birth (kg/m²).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 14 Gestational weight gain: weight at birth (kg).
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Analysis 5.14

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 14 Gestational weight gain: weight at birth (kg).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 15 Insulin sensitivity: during intervention (38 week) insulin (mU/L).
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Analysis 5.15

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 15 Insulin sensitivity: during intervention (38 week) insulin (mU/L).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 16 Insulin sensitivity: during intervention (38 week) insulin sensitivity (10‐5 min‐1 per mU/L min).
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Analysis 5.16

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 16 Insulin sensitivity: during intervention (38 week) insulin sensitivity (10‐5 min‐1 per mU/L min).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 17 Insulin sensitivity: end of intervention IAI.
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Analysis 5.17

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 17 Insulin sensitivity: end of intervention IAI.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 18 Use of additional pharmacotherapy.
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Analysis 5.18

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 18 Use of additional pharmacotherapy.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 19 Glycaemic control: during intervention (38 week) fasting blood glucose (mmol/L).
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Analysis 5.19

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 19 Glycaemic control: during intervention (38 week) fasting blood glucose (mmol/L).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 20 Glycaemic control: during intervention (38 week) postprandial glucose (mmol/L).
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Analysis 5.20

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 20 Glycaemic control: during intervention (38 week) postprandial glucose (mmol/L).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 21 Glycaemic control: during intervention (38 week) HbA1c (%).
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Analysis 5.21

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 21 Glycaemic control: during intervention (38 week) HbA1c (%).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 22 Glycaemic control: end of intervention fasting blood glucose (mmol/L).
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Analysis 5.22

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 22 Glycaemic control: end of intervention fasting blood glucose (mmol/L).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 23 Glycaemic control: end of intervention 2‐hour postprandial blood glucose (mmol/L).
Figures and Tables -
Analysis 5.23

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 23 Glycaemic control: end of intervention 2‐hour postprandial blood glucose (mmol/L).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 24 BMI 5‐9 months postpartum (kg/m²).
Figures and Tables -
Analysis 5.24

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 24 BMI 5‐9 months postpartum (kg/m²).

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 25 Impaired glucose tolerance: 'borderline' OGTT 1‐2 weeks postpartum.
Figures and Tables -
Analysis 5.25

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 25 Impaired glucose tolerance: 'borderline' OGTT 1‐2 weeks postpartum.

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 26 Impaired glucose tolerance: 'borderline' OGTT 4‐13 months postpartum.
Figures and Tables -
Analysis 5.26

Comparison 5 High unsaturated fat diet versus low unsaturated fat diet with matching calories, Outcome 26 Impaired glucose tolerance: 'borderline' OGTT 4‐13 months postpartum.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 1 Large‐for‐gestational age.
Figures and Tables -
Analysis 6.1

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 1 Large‐for‐gestational age.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 2 Caesarean section.
Figures and Tables -
Analysis 6.2

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 2 Caesarean section.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 3 Type 2 diabetes mellitus at 3 months postpartum.
Figures and Tables -
Analysis 6.3

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 3 Type 2 diabetes mellitus at 3 months postpartum.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 4 Gestational age at birth (weeks).
Figures and Tables -
Analysis 6.4

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 4 Gestational age at birth (weeks).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 5 Preterm birth.
Figures and Tables -
Analysis 6.5

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 5 Preterm birth.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 6 Macrosomia (> 4000 g).
Figures and Tables -
Analysis 6.6

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 6 Macrosomia (> 4000 g).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 7 Small‐for‐gestational age.
Figures and Tables -
Analysis 6.7

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 7 Small‐for‐gestational age.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 8 Birthweight (g).
Figures and Tables -
Analysis 6.8

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 8 Birthweight (g).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 9 Head circumference at birth (cm).
Figures and Tables -
Analysis 6.9

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 9 Head circumference at birth (cm).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 10 Length at birth (cm).
Figures and Tables -
Analysis 6.10

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 10 Length at birth (cm).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 11 Ponderal index at birth (kg/m³).
Figures and Tables -
Analysis 6.11

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 11 Ponderal index at birth (kg/m³).

Study

Low‐GI diet (N =31)

High‐fibre moderate‐GI diet (N =21)

P value

Weight for age percentile (adjusted for breastfeeding status)

Louie 2011

Mean (95% CI): 69.6 (60.5–78.8)

Mean (95% CI): 68.0 (56.9–79.1)

0.720

Length for age percentile (adjusted for breastfeeding status)

Louie 2011

Mean (95% CI): 47.9 (38.6–57.2)

Mean (95% CI): 48.1 (36.9–59.3)

0.977

Weight for length percentile (adjusted for breastfeeding status)

Louie 2011

Mean (95% CI): 72.4 (61.2–83.6)

Mean (95% CI): 64.6 (51.0–78.1)

0.511

Figures and Tables -
Analysis 6.12

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 12 Weight and height at 3 months postpartum.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 13 Weight gain during pregnancy (kg).
Figures and Tables -
Analysis 6.13

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 13 Weight gain during pregnancy (kg).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 14 Adherence to dietary intervention.
Figures and Tables -
Analysis 6.14

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 14 Adherence to dietary intervention.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 15 Insulin sensitivity: end of intervention: HOMA2‐IR (%).
Figures and Tables -
Analysis 6.15

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 15 Insulin sensitivity: end of intervention: HOMA2‐IR (%).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 16 Insulin sensitivity: end of intervention insulin (pmol/L).
Figures and Tables -
Analysis 6.16

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 16 Insulin sensitivity: end of intervention insulin (pmol/L).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 17 Use of additional pharmacotherapy.
Figures and Tables -
Analysis 6.17

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 17 Use of additional pharmacotherapy.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 18 Glycaemic control: end of intervention blood glucose (mmol/L).
Figures and Tables -
Analysis 6.18

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 18 Glycaemic control: end of intervention blood glucose (mmol/L).

Study

Low‐GI diet (N =43)

High‐fibre moderate‐GI diet (N =41)

P value

Louie 2011

Mean (SEM): 5.5 (0.1)

Mean (SEM): 5.5 (0.0)

0.665

Figures and Tables -
Analysis 6.19

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 19 Glycaemic control: end of intervention HbA1c (%).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 20 Return to pre‐pregnancy weight at 3 months postpartum.
Figures and Tables -
Analysis 6.20

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 20 Return to pre‐pregnancy weight at 3 months postpartum.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 21 BMI at 3 months postpartum (kg/m²).
Figures and Tables -
Analysis 6.21

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 21 BMI at 3 months postpartum (kg/m²).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 22 Impaired glucose tolerance at 3 months postpartum.
Figures and Tables -
Analysis 6.22

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 22 Impaired glucose tolerance at 3 months postpartum.

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 23 Insulin sensitivity at 3 months postpartum (insulin (pmol/L)).
Figures and Tables -
Analysis 6.23

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 23 Insulin sensitivity at 3 months postpartum (insulin (pmol/L)).

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 24 Insulin sensitivity at 3 months postpartum (HOMA‐IR (%)).
Figures and Tables -
Analysis 6.24

Comparison 6 Low‐GI diet versus high‐fibre moderate‐GI diet, Outcome 24 Insulin sensitivity at 3 months postpartum (HOMA‐IR (%)).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 1 Large‐for‐gestational age.
Figures and Tables -
Analysis 7.1

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 1 Large‐for‐gestational age.

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 2 Caesarean section.
Figures and Tables -
Analysis 7.2

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 2 Caesarean section.

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 3 Preterm birth (< 37 weeks' gestation).
Figures and Tables -
Analysis 7.3

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 3 Preterm birth (< 37 weeks' gestation).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 4 Gestational weight gain: BMI at end of intervention (kg/m²).
Figures and Tables -
Analysis 7.4

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 4 Gestational weight gain: BMI at end of intervention (kg/m²).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 5 Gestational weight gain: weight at end of intervention (kg).
Figures and Tables -
Analysis 7.5

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 5 Gestational weight gain: weight at end of intervention (kg).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 6 Insulin sensitivity: end of intervention HOMA‐IR.
Figures and Tables -
Analysis 7.6

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 6 Insulin sensitivity: end of intervention HOMA‐IR.

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 7 Insulin sensitivity: end of intervention fasting insulin (µU/mL).
Figures and Tables -
Analysis 7.7

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 7 Insulin sensitivity: end of intervention fasting insulin (µU/mL).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 8 Use of additional pharmacotherapy.
Figures and Tables -
Analysis 7.8

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 8 Use of additional pharmacotherapy.

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 9 Glycaemic control: end of intervention fasting glucose (mg/dL).
Figures and Tables -
Analysis 7.9

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 9 Glycaemic control: end of intervention fasting glucose (mg/dL).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 10 Glycaemic control: end of intervention postprandial glucose (mg/dL).
Figures and Tables -
Analysis 7.10

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 10 Glycaemic control: end of intervention postprandial glucose (mg/dL).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 11 Glycaemic control: end of intervention HbA1c (%).
Figures and Tables -
Analysis 7.11

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 11 Glycaemic control: end of intervention HbA1c (%).

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 12 Length of postnatal stay (baby): stay > 4 days.
Figures and Tables -
Analysis 7.12

Comparison 7 Diet recommendation + diet‐related behavioural advice versus diet recommendation only, Outcome 12 Length of postnatal stay (baby): stay > 4 days.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 1 Hypertensive disorders of pregnancy: pre‐eclampsia.
Figures and Tables -
Analysis 8.1

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 1 Hypertensive disorders of pregnancy: pre‐eclampsia.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 2 Caesarean section.
Figures and Tables -
Analysis 8.2

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 2 Caesarean section.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 3 Gestational age at birth (weeks).
Figures and Tables -
Analysis 8.3

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 3 Gestational age at birth (weeks).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 4 Preterm birth (< 37 weeks' gestation).
Figures and Tables -
Analysis 8.4

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 4 Preterm birth (< 37 weeks' gestation).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 5 Macrosomia (> 4000 g).
Figures and Tables -
Analysis 8.5

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 5 Macrosomia (> 4000 g).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 6 Birthweight (g).
Figures and Tables -
Analysis 8.6

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 6 Birthweight (g).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 7 Head circumference at birth (cm).
Figures and Tables -
Analysis 8.7

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 7 Head circumference at birth (cm).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 8 Length at birth (cm).
Figures and Tables -
Analysis 8.8

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 8 Length at birth (cm).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 9 Neonatal hypoglycaemia.
Figures and Tables -
Analysis 8.9

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 9 Neonatal hypoglycaemia.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 10 Neonatal hyperbilirubinaemia.
Figures and Tables -
Analysis 8.10

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 10 Neonatal hyperbilirubinaemia.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 11 Gestational weight gain: BMI at end of intervention (kg/m²).
Figures and Tables -
Analysis 8.11

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 11 Gestational weight gain: BMI at end of intervention (kg/m²).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 12 Gestational weight gain: weight at end of intervention (kg).
Figures and Tables -
Analysis 8.12

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 12 Gestational weight gain: weight at end of intervention (kg).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 13 Insulin sensitivity: end of intervention HOMA‐IR.
Figures and Tables -
Analysis 8.13

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 13 Insulin sensitivity: end of intervention HOMA‐IR.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 14 Insulin sensitivity: end of intervention QUICKI.
Figures and Tables -
Analysis 8.14

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 14 Insulin sensitivity: end of intervention QUICKI.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 15 Insulin sensitivity: end of intervention insulin (µIU/mL).
Figures and Tables -
Analysis 8.15

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 15 Insulin sensitivity: end of intervention insulin (µIU/mL).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 16 Use of additional pharmacotherapy.
Figures and Tables -
Analysis 8.16

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 16 Use of additional pharmacotherapy.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 17 Glycaemic control: end of intervention fasting plasma glucose (mg/dL).
Figures and Tables -
Analysis 8.17

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 17 Glycaemic control: end of intervention fasting plasma glucose (mg/dL).

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 18 Number of antenatal visits or admissions: maternal hospitalisation.
Figures and Tables -
Analysis 8.18

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 18 Number of antenatal visits or admissions: maternal hospitalisation.

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 19 Neonatal intensive care unit admission: neonatal hospitalisations.
Figures and Tables -
Analysis 8.19

Comparison 8 Soy protein‐enriched diet versus no soy protein diet, Outcome 19 Neonatal intensive care unit admission: neonatal hospitalisations.

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 1 Gestational age at birth (weeks).
Figures and Tables -
Analysis 9.1

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 1 Gestational age at birth (weeks).

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 2 Birthweight (g).
Figures and Tables -
Analysis 9.2

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 2 Birthweight (g).

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 3 Gestational weight gain (kg).
Figures and Tables -
Analysis 9.3

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 3 Gestational weight gain (kg).

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 4 Use of additional pharmacotherapy.
Figures and Tables -
Analysis 9.4

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 4 Use of additional pharmacotherapy.

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 5 Glycaemic control during/at end of intervention: mean blood glucose (mg/dL).
Figures and Tables -
Analysis 9.5

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 5 Glycaemic control during/at end of intervention: mean blood glucose (mg/dL).

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 6 Maternal hypoglycaemia: mean number of events.
Figures and Tables -
Analysis 9.6

Comparison 9 High‐fibre diet versus standard‐fibre diet, Outcome 6 Maternal hypoglycaemia: mean number of events.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 1 Large‐for‐gestational age.
Figures and Tables -
Analysis 10.1

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 1 Large‐for‐gestational age.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 2 Neonatal composite outcome: hypoglycaemia, neonatal asphyxia, respiratory distress syndrome, and hyperbilirubinaemia, hypocalcaemia.
Figures and Tables -
Analysis 10.2

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 2 Neonatal composite outcome: hypoglycaemia, neonatal asphyxia, respiratory distress syndrome, and hyperbilirubinaemia, hypocalcaemia.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 3 Hypertensive disorders of pregnancy: gestational hypertension.
Figures and Tables -
Analysis 10.3

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 3 Hypertensive disorders of pregnancy: gestational hypertension.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 4 Caesarean section.
Figures and Tables -
Analysis 10.4

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 4 Caesarean section.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 5 Gestational age at birth (weeks).
Figures and Tables -
Analysis 10.5

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 5 Gestational age at birth (weeks).

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 6 Macrosomia (> 4000 g).
Figures and Tables -
Analysis 10.6

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 6 Macrosomia (> 4000 g).

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 7 Small‐for‐gestational age.
Figures and Tables -
Analysis 10.7

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 7 Small‐for‐gestational age.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 8 Birthweight (g).
Figures and Tables -
Analysis 10.8

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 8 Birthweight (g).

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 9 Respiratory distress syndrome.
Figures and Tables -
Analysis 10.9

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 9 Respiratory distress syndrome.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 10 Neonatal hypoglycaemia.
Figures and Tables -
Analysis 10.10

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 10 Neonatal hypoglycaemia.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 11 Neonatal hyperbilirubinaemia.
Figures and Tables -
Analysis 10.11

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 11 Neonatal hyperbilirubinaemia.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 12 Neonatal hypocalcaemia.
Figures and Tables -
Analysis 10.12

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 12 Neonatal hypocalcaemia.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 13 Gestational weight gain (kg).
Figures and Tables -
Analysis 10.13

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 13 Gestational weight gain (kg).

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 14 Adherence to dietary intervention: good adherence.
Figures and Tables -
Analysis 10.14

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 14 Adherence to dietary intervention: good adherence.

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 15 Use of additional pharmacotherapy.
Figures and Tables -
Analysis 10.15

Comparison 10 Ethnic‐specific diet versus standard healthy diet, Outcome 15 Use of additional pharmacotherapy.

Summary of findings for the main comparison. Summary of findings: Low‐moderate GI diet versus moderate‐high GI diet (maternal outcomes)

Low‐moderate GI diet versus moderate‐high GI diet (maternal outcomes)

Patient or population: pregnant women with GDM

Settings: 4 RCTs in Australia, Canada, China and Mexico

Intervention: low‐moderate GI diet

Comparison: moderate‐high GI diet

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with moderate‐high GI diet

Risk with low‐moderate GI diet

Hypertensive disorders of pregnancy: severe hypertension or pre‐eclampsia

Study population

RR 1.02 (0.07 to 15.86)

95 (1 RCT)

⊕⊝⊝⊝

VERY LOW1,2

1 RCT in China

21 per 1000

21 per 1000 (2 to 333)

Hypertensive disorders of pregnancy: eclampsia

Study population

RR 0.34 (0.01 to 8.14)

83 (1 RCT)

⊕⊝⊝⊝

VERY LOW1,2

1 RCT in China

24 per 1000

8 per 1000 (0 to 195)

Caesarean section

Study population

RR 0.66 (0.29 to 1.47)

63 (1 RCT)

⊕⊕⊝⊝

LOW3,4

1 RCT in Australia

344 per 1000

227 per 1000 (100 to 506)

Induction of labour

Study population

RR 0.88 (0.33 to 2.34)

63 (1 RCT)

⊕⊕⊝⊝

LOW3,4

1 RCT in Australia

219 per 1000

193 per 1000 (72 to 512)

Perineal trauma

Not reported

Type 2 diabetes mellitus

Not reported

Postnatal depression

Not reported

Postnatal weight retention or return to pre‐pregnancy weight

Not reported

*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; GDM: gestational diabetes mellitus; GI: glycaemic index; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Design limitations: one study at high risk of selection and performance bias; unclear risk of detection bias.

2Imprecision: wide confidence interval crossing the line of no effect, few events and small sample size.

3Design limitations: one study at unclear risk of selection and detection bias; high risk of performance bias.

4Imprecision: wide confidence interval crossing the line of no effect and small sample size.

Figures and Tables -
Summary of findings for the main comparison. Summary of findings: Low‐moderate GI diet versus moderate‐high GI diet (maternal outcomes)
Summary of findings 2. Summary of findings: Low‐moderate GI diet versus moderate‐high GI diet (neonatal/child/adulthood outcomes)

Low‐moderate GI diet versus moderate‐high GI diet (neonatal/child/adulthood outcomes)

Patient or population: pregnant women with GDM

Settings: 4 RCTs in Australia, Canada, China and Mexico

Intervention: low‐moderate GI diet

Comparison: moderate‐high GI diet

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with moderate‐high GI diet

Risk with low‐moderate GI diet

Large‐for‐gestational age

Study population

RR 0.71 (0.22 to 2.34)

89 (2 RCTs)

⊕⊕⊝⊝

LOW1,2

2 RCTs in Australia and Canada

146 per 1000

104 per 1000 (32 to 342)

Perinatal mortality

Not reported

Neonatal mortality or morbidity composite

Not reported

Neonatal hypoglycaemia

Not reported

Childhood/adulthood neurosensory disability

Not reported

Childhood/adulthood adiposity

Not reported

Childhood/adulthood type 2 diabetes mellitus

Not reported

*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; GDM: gestational diabetes mellitus; GI: glycaemic index; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Design limitations: one study at unclear risk of selection bias; two at high risk of performance bias and unclear risk of detection bias.

2Imprecision: wide confidence interval crossing the line of no effect and small sample sizes.

Figures and Tables -
Summary of findings 2. Summary of findings: Low‐moderate GI diet versus moderate‐high GI diet (neonatal/child/adulthood outcomes)
Summary of findings 3. Summary of findings: Energy‐restricted diet versus no energy‐restricted diet (maternal outcomes)

Energy‐restricted diet versus no energy‐restricted diet

Patient or population: pregnant women with GDM

Settings: 3 RCTs in Australia, Canada and the United States

Intervention: energy‐restricted diet

Comparison: no energy‐restricted diet

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with no energy‐restricted diet

Risk with energy‐restricted diet

Hypertensive disorders of pregnancy: pre‐eclampsia

Study population

RR 1.00 (0.51 to 1.97)

117 (1 RCT)

⊕⊕⊝⊝

LOW1,2

1 RCT in Australia

222 per 1000

222 per 1000 (113 to 437)

Caesarean section

Study population

RR 1.12 (0.80 to 1.56)

420 (2 RCTs)

⊕⊕⊝⊝

LOW3,4

2 RCTs in Australia and Canada

228 per 1000

255 per 1000 (182 to 356)

Induction of labour

Study population

RR 1.02 (0.68 to 1.53)

114 (1 RCT)

⊕⊕⊝⊝

LOW1,2

1 RCT in Australia

451 per 1000

460 per 1000 (307 to 690)

Perineal trauma

Not reported

Type 2 diabetes mellitus

Not reported

Postnatal depression

Not reported

Postnatal weight retention or return to pre‐pregnancy weight

Not reported

*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; GDM: gestational diabetes mellitus; GI: glycaemic index; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Design limitations: one study at unclear risk of selection and detection bias.

2Imprecision: wide confidence interval crossing the line of no effect and small sample size.

3Design limitations: two studies at unclear risk of selection bias; one at high risk of performance bias and unclear risk of detection bias.

4Imprecision: wide confidence interval crossing the line of no effect.

Figures and Tables -
Summary of findings 3. Summary of findings: Energy‐restricted diet versus no energy‐restricted diet (maternal outcomes)
Summary of findings 4. Summary of findings: Energy‐restricted diet versus no energy‐restricted diet (neonatal/child/adulthood outcomes)

Energy‐restricted diet versus no energy‐restricted diet (neonatal/child/adulthood outcomes)

Patient or population: pregnant women with GDM

Settings: 3 RCTs in Australia, Canada and the United States

Intervention: energy‐restricted diet

Comparison: no energy‐restricted diet

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with no energy‐restricted diet

Risk with energy‐restricted diet

Large‐for‐gestational age

Study population

RR 1.17 (0.65 to 2.12)

123 (1 RCT)

⊕⊕⊝⊝

LOW1,2

1 RCT in Australia

246 per 1000

288 per 1000 (160 to 522)

Perinatal mortality

Study population

Not estimable

423 (2 RCTs)

⊕⊕⊝⊝

LOW3,4

No events; 2 RCTs in Australia and Canada

0 per 1000

0 per 1000 (0 to 0)

Neonatal mortality or morbidity composite

Not reported

Neonatal hypoglycaemia

Study population

RR 1.06 (0.48 to 2.32)

408 (2 RCTs)

⊕⊝⊝⊝

VERY LOW3,5,6

2 RCTs in Australia and Canada

190 per 1000

201 per 1000 (91 to 441)

Childhood/adulthood neurosensory disability

Not reported

Childhood/adulthood adiposity

Not reported

Childhood/adulthood type 2 diabetes mellitus

Not reported

*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; GDM: gestational diabetes mellitus; GI: glycaemic index; RR: risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Design limitations: one study at unclear risk of selection and detection bias.

2Imprecision: wide confidence interval crossing the line of no effect and small sample size.

3Design limitations: two studies at unclear risk of selection bias; one at high risk of performance bias and unclear risk of detection bias.

4Imprecision: no events; relatively small sample sizes.

5Imprevision: wide confidence interval crossing the line of no effect.

6Inconsistency: substantial heterogeneity: I² = 75%.

Figures and Tables -
Summary of findings 4. Summary of findings: Energy‐restricted diet versus no energy‐restricted diet (neonatal/child/adulthood outcomes)
Comparison 1. Low‐moderate GI diet versus moderate‐high GI diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

2

89

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.22, 2.34]

2 Hypertensive disorders of pregnancy (severe hypertension or pre‐eclampsia) Show forest plot

1

95

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.07, 15.86]

3 Hypertensive disorders of pregnancy (eclampsia) Show forest plot

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.01, 8.14]

4 Caesarean section Show forest plot

1

63

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.29, 1.47]

5 Gestational age at birth (weeks) Show forest plot

1

62

Mean Difference (IV, Fixed, 95% CI)

0.30 [‐0.30, 0.90]

6 Preterm birth Show forest plot

2

146

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.22, 1.85]

7 Macrosomia Show forest plot

3

172

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.16, 2.26]

8 Small‐for‐gestational age Show forest plot

1

63

Risk Ratio (M‐H, Fixed, 95% CI)

5.16 [0.26, 103.27]

9 Birthweight (g) Show forest plot

2

145

Mean Difference (IV, Fixed, 95% CI)

‐55.98 [‐201.90, 89.95]

10 Head circumference at birth (cm) Show forest plot

1

59

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐0.58, 1.38]

11 Length at birth (cm) Show forest plot

1

60

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐1.54, 0.54]

12 Ponderal index at birth (kg/m³) Show forest plot

1

60

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.03, 0.23]

13 Normal vaginal birth Show forest plot

1

63

Risk Ratio (M‐H, Fixed, 95% CI)

1.35 [0.89, 2.07]

14 Operative vaginal birth Show forest plot

1

63

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.16, 2.37]

15 Induction of labour Show forest plot

1

63

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.33, 2.34]

16 Postpartum haemorrhage Show forest plot

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.15, 6.93]

17 Postpartum infection Show forest plot

1

83

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.01, 8.14]

18 Gestational weight gain (kg) Show forest plot

1

83

Mean Difference (IV, Fixed, 95% CI)

‐0.47 [‐2.18, 1.24]

19 Use of additional pharmacotherapy Show forest plot

4

221

Risk Ratio (M‐H, Random, 95% CI)

0.82 [0.39, 1.74]

20 Glycaemic control: end of intervention fasting plasma glucose (mmol/L) Show forest plot

1

83

Mean Difference (IV, Fixed, 95% CI)

‐0.15 [‐0.55, 0.25]

21 Glycaemic control: end of intervention 2‐hour postprandial glucose (mmol/L) Show forest plot

1

83

Mean Difference (IV, Fixed, 95% CI)

‐0.71 [‐1.21, ‐0.21]

22 Glycaemic control: end of intervention HbA1c (%) Show forest plot

1

83

Mean Difference (IV, Fixed, 95% CI)

0.01 [‐0.18, 0.20]

Figures and Tables -
Comparison 1. Low‐moderate GI diet versus moderate‐high GI diet
Comparison 2. Energy‐restricted diet versus no energy‐restricted diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

1

123

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.65, 2.12]

2 Perinatal mortality (stillbirth and neonatal mortality) Show forest plot

2

423

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Hypertensive disorders of pregnancy: pre‐eclampsia Show forest plot

1

117

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.51, 1.97]

4 Caesarean section Show forest plot

2

420

Risk Ratio (M‐H, Fixed, 95% CI)

1.12 [0.80, 1.56]

5 Stillbirth Show forest plot

2

423

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 Neonatal mortality Show forest plot

2

423

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Gestational age at birth (weeks) Show forest plot

2

423

Mean Difference (IV, Random, 95% CI)

‐0.16 [‐0.67, 0.36]

8 Macrosomia (> 4000 g) Show forest plot

2

421

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.64, 1.53]

9 Macrosomia (> 4500 g) Show forest plot

1

299

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.33, 3.05]

10 Birthweight (g) Show forest plot

1

299

Mean Difference (IV, Fixed, 95% CI)

‐107.0 [‐240.32, 26.32]

11 Shoulder dystocia Show forest plot

2

418

Risk Ratio (M‐H, Fixed, 95% CI)

0.12 [0.01, 2.26]

12 Bone fracture Show forest plot

1

299

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Nerve palsy Show forest plot

1

299

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

14 Neonatal hypoglycaemia Show forest plot

2

408

Risk Ratio (M‐H, Random, 95% CI)

1.06 [0.48, 2.32]

15 Neonatal hyperbilirubinemia Show forest plot

1

299

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.33, 1.98]

16 Neonatal hypocalcaemia Show forest plot

1

299

Risk Ratio (M‐H, Fixed, 95% CI)

1.36 [1.00, 1.86]

17 Normal vaginal birth Show forest plot

2

420

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.86, 1.08]

18 Operative vaginal birth Show forest plot

1

121

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.38, 2.54]

19 Induction of labour Show forest plot

1

114

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.68, 1.53]

20 Gestational weight gain (kg) Show forest plot

1

117

Mean Difference (IV, Fixed, 95% CI)

1.88 [‐1.96, 5.72]

21 Gestational weight gain: weight at birth (kg) Show forest plot

1

299

Mean Difference (IV, Fixed, 95% CI)

‐3.15 [‐7.29, 0.99]

22 Insulin sensitivity: during intervention fasting plasma insulin (pM) Show forest plot

1

12

Mean Difference (IV, Fixed, 95% CI)

100.0 [‐26.02, 226.02]

23 Insulin sensitivity: end of intervention fasting plasma insulin (pM) Show forest plot

1

12

Mean Difference (IV, Fixed, 95% CI)

‐20.0 [‐127.70, 87.70]

24 Use of additional pharmacotherapy Show forest plot

2

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

25 Glycaemic control: during intervention preprandial/fasting glucose (mmol/L) Show forest plot

2

311

Mean Difference (IV, Random, 95% CI)

0.21 [‐0.58, 0.99]

26 Glycaemic control: during intervention 24 hour mean plasma glucose (mmol/L) Show forest plot

1

12

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.82, 1.02]

27 Glycaemic control: during intervention 1 hour postprandial glucose (mmol/L) Show forest plot

1

299

Mean Difference (IV, Fixed, 95% CI)

‐0.25 [‐0.68, 0.18]

28 Glycaemic control: end of intervention preprandial/fasting glucose (mmol/L) Show forest plot

2

311

Mean Difference (IV, Fixed, 95% CI)

‐0.23 [‐0.44, ‐0.03]

29 Glycaemic control: end of intervention 24‐hour mean plasma glucose (mmol/L) Show forest plot

1

12

Mean Difference (IV, Fixed, 95% CI)

‐1.30 [‐2.25, ‐0.35]

30 Glycaemic control: end of intervention 1‐hour postprandial glucose (mmol/L) Show forest plot

1

299

Mean Difference (IV, Fixed, 95% CI)

‐0.51 [‐0.89, ‐0.13]

31 Glycaemic control: during/at end of intervention fasting glucose (mmol/L) Show forest plot

1

117

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.18, 0.38]

32 Glycaemic control: during/at end of intervention mean plasma glucose (mmol/L) Show forest plot

1

117

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.34, 0.54]

33 Glycaemic control: during/at end of intervention mean HbA1c (%) Show forest plot

1

117

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐0.64, 0.24]

Figures and Tables -
Comparison 2. Energy‐restricted diet versus no energy‐restricted diet
Comparison 3. DASH diet versus control diet with matching macronutrient contents

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Hypertensive disorders of pregnancy: pre‐eclampsia Show forest plot

3

136

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.31, 3.26]

2 Caesarean section Show forest plot

2

86

Risk Ratio (M‐H, Fixed, 95% CI)

0.53 [0.37, 0.76]

3 Gestational age at birth (weeks) Show forest plot

1

52

Mean Difference (IV, Fixed, 95% CI)

0.20 [‐0.45, 0.85]

4 Macrosomia (≥ 4000 g) Show forest plot

1

52

Risk Ratio (M‐H, Fixed, 95% CI)

0.1 [0.01, 0.73]

5 Birthweight (g) Show forest plot

2

86

Mean Difference (IV, Fixed, 95% CI)

‐581.27 [‐790.32, ‐372.22]

6 Head circumference at birth (cm) Show forest plot

1

52

Mean Difference (IV, Fixed, 95% CI)

‐0.90 [‐1.44, ‐0.36]

7 Length at birth(cm) Show forest plot

1

52

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐1.59, 0.59]

8 Ponderal index at birth (kg/m³) Show forest plot

1

52

Mean Difference (IV, Fixed, 95% CI)

‐0.37 [‐0.54, ‐0.20]

9 Placental abruption Show forest plot

1

58

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.13, 70.74]

10 Gestational weight gain: BMI at end of intervention (kg/m²) Show forest plot

2

66

Mean Difference (IV, Random, 95% CI)

‐0.83 [‐3.76, 2.11]

11 Gestational weight gain: weight at end of intervention (kg) Show forest plot

2

66

Mean Difference (IV, Fixed, 95% CI)

‐2.88 [‐8.48, 2.71]

12 Insulin sensitivity: end of intervention HOMA‐IR Show forest plot

1

32

Mean Difference (IV, Fixed, 95% CI)

1.00 [‐1.34, ‐0.66]

13 Insulin sensitivity: end of intervention insulin (µIU/mL) Show forest plot

1

32

Mean Difference (IV, Fixed, 95% CI)

‐3.26 [‐4.42, ‐2.10]

14 Use of additional pharmacotherapy Show forest plot

2

86

Risk Ratio (M‐H, Fixed, 95% CI)

0.28 [0.14, 0.53]

15 Glycaemic control: end of intervention fasting blood glucose (mmol/L) Show forest plot

2

66

Mean Difference (IV, Fixed, 95% CI)

‐0.42 [‐0.53, ‐0.32]

16 Glycaemic control: at end of intervention HbA1c (%) Show forest plot

1

34

Mean Difference (IV, Fixed, 95% CI)

‐0.25 [‐0.76, 0.26]

Figures and Tables -
Comparison 3. DASH diet versus control diet with matching macronutrient contents
Comparison 4. Low‐carbohydrate diet versus high‐carbohydrate diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

1

149

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.13, 1.95]

2 Perinatal mortality (stillbirth and neonatal mortality) Show forest plot

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.12, 72.49]

3 Hypertensive disorders of pregnancy: maternal hypertension Show forest plot

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.4 [0.13, 1.22]

4 Caesarean section Show forest plot

2

179

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [0.84, 1.99]

5 Stillbirth Show forest plot

1

150

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.12, 72.49]

6 Gestational age at birth (weeks) Show forest plot

2

180

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.42, 0.62]

7 Macrosomia (> 4000 g) Show forest plot

2

179

Risk Ratio (M‐H, Fixed, 95% CI)

0.20 [0.02, 1.69]

8 Small‐for‐gestational age Show forest plot

1

149

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.29, 1.56]

9 Birthweight (g) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

22.0 [‐241.06, 285.06]

10 Neonatal hypoglycaemia Show forest plot

1

149

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.39, 2.12]

11 Normal vaginal birth Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.39, 1.54]

12 Operative vaginal birth Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.07, 14.55]

13 Gestational weight gain: maternal weight gain (kg) Show forest plot

1

145

Mean Difference (IV, Fixed, 95% CI)

‐0.90 [‐1.60, ‐0.20]

14 Adherence to dietary intervention: fully applied the recommended menu Show forest plot

1

30

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.73, 1.62]

15 Use of additional pharmacotherapy. Show forest plot

2

180

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.77, 1.37]

16 Glycaemic control: end of intervention fasting blood glucose (mg/dL) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

5.0 [‐0.01, 10.01]

17 Glycaemic control: end of intervention 2‐hour post breakfast blood glucose (mg/dL) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

5.0 [‐1.60, 11.60]

18 Glycaemic control: end of intervention 2‐hour post lunch blood glucose (mg/dL) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

3.0 [‐2.77, 8.77]

19 Glycaemic control: end of intervention 2‐hour post dinner blood glucose (mg/dL) Show forest plot

1

30

Mean Difference (IV, Fixed, 95% CI)

6.0 [‐1.47, 13.47]

Figures and Tables -
Comparison 4. Low‐carbohydrate diet versus high‐carbohydrate diet
Comparison 5. High unsaturated fat diet versus low unsaturated fat diet with matching calories

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.21, 1.37]

2 Hypertensive disorders of pregnancy: pre‐eclampsia Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Hypertensive disorders of pregnancy: hypertension in pregnancy Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.06, 5.26]

4 Caesarean section Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.07, 15.50]

5 Type 2 diabetes: 'diabetic' OGTT 1‐2 weeks postpartum Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

2.0 [0.45, 8.94]

6 Type 2 diabetes: 'diabetic' OGTT 4‐13 months postpartum Show forest plot

1

6

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.10, 9.61]

7 Gestational age at birth (weeks) Show forest plot

2

111

Mean Difference (IV, Fixed, 95% CI)

0.25 [‐0.51, 1.01]

8 Preterm birth Show forest plot

1

84

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 Macrosomia (> 4000 g) Show forest plot

2

111

Risk Ratio (M‐H, Fixed, 95% CI)

0.53 [0.18, 1.56]

10 Birthweight (g) Show forest plot

2

111

Mean Difference (IV, Fixed, 95% CI)

‐138.19 [‐292.59, 16.21]

11 Placental abruption Show forest plot

1

27

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Gestational weight gain (kg) Show forest plot

1

84

Mean Difference (IV, Fixed, 95% CI)

‐1.98 [‐4.32, 0.36]

13 Gestational weight gain: BMI at birth (kg/m²) Show forest plot

1

27

Mean Difference (IV, Fixed, 95% CI)

3.90 [2.41, 5.39]

14 Gestational weight gain: weight at birth (kg) Show forest plot

1

27

Mean Difference (IV, Fixed, 95% CI)

11.90 [7.47, 16.33]

15 Insulin sensitivity: during intervention (38 week) insulin (mU/L) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

4.40 [2.59, 6.21]

16 Insulin sensitivity: during intervention (38 week) insulin sensitivity (10‐5 min‐1 per mU/L min) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

‐0.08 [‐0.21, 0.05]

17 Insulin sensitivity: end of intervention IAI Show forest plot

1

84

Mean Difference (IV, Fixed, 95% CI)

0.04 [‐0.28, 0.36]

18 Use of additional pharmacotherapy Show forest plot

2

111

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

19 Glycaemic control: during intervention (38 week) fasting blood glucose (mmol/L) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

0.5 [0.30, 0.70]

20 Glycaemic control: during intervention (38 week) postprandial glucose (mmol/L) Show forest plot

1

25

Mean Difference (IV, Fixed, 95% CI)

0.90 [0.58, 1.22]

21 Glycaemic control: during intervention (38 week) HbA1c (%) Show forest plot

1

25

Mean Difference (IV, Fixed, 95% CI)

0.40 [0.32, 0.48]

22 Glycaemic control: end of intervention fasting blood glucose (mmol/L) Show forest plot

1

84

Mean Difference (IV, Fixed, 95% CI)

0.18 [‐0.17, 0.53]

23 Glycaemic control: end of intervention 2‐hour postprandial blood glucose (mmol/L) Show forest plot

1

84

Mean Difference (IV, Fixed, 95% CI)

‐0.02 [‐0.29, 0.25]

24 BMI 5‐9 months postpartum (kg/m²) Show forest plot

1

27

Mean Difference (IV, Fixed, 95% CI)

4.10 [2.34, 5.86]

25 Impaired glucose tolerance: 'borderline' OGTT 1‐2 weeks postpartum Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.30, 7.43]

26 Impaired glucose tolerance: 'borderline' OGTT 4‐13 months postpartum Show forest plot

1

7

Risk Ratio (M‐H, Fixed, 95% CI)

0.27 [0.01, 4.93]

Figures and Tables -
Comparison 5. High unsaturated fat diet versus low unsaturated fat diet with matching calories
Comparison 6. Low‐GI diet versus high‐fibre moderate‐GI diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

1

92

Risk Ratio (M‐H, Fixed, 95% CI)

2.87 [0.61, 13.50]

2 Caesarean section Show forest plot

1

92

Risk Ratio (M‐H, Fixed, 95% CI)

1.91 [0.91, 4.03]

3 Type 2 diabetes mellitus at 3 months postpartum Show forest plot

1

58

Risk Ratio (M‐H, Fixed, 95% CI)

0.76 [0.11, 5.01]

4 Gestational age at birth (weeks) Show forest plot

1

92

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.39, 0.19]

5 Preterm birth Show forest plot

1

96

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.14, 6.53]

6 Macrosomia (> 4000 g) Show forest plot

1

92

Risk Ratio (M‐H, Fixed, 95% CI)

0.32 [0.03, 2.96]

7 Small‐for‐gestational age Show forest plot

1

92

Risk Ratio (M‐H, Fixed, 95% CI)

1.20 [0.34, 4.18]

8 Birthweight (g) Show forest plot

1

92

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐277.18, 277.18]

9 Head circumference at birth (cm) Show forest plot

1

82

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐0.91, 0.51]

10 Length at birth (cm) Show forest plot

1

92

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.83, 0.83]

11 Ponderal index at birth (kg/m³) Show forest plot

1

92

Mean Difference (IV, Fixed, 95% CI)

0.20 [‐0.79, 1.19]

12 Weight and height at 3 months postpartum Show forest plot

Other data

No numeric data

12.1 Weight for age percentile (adjusted for breastfeeding status)

Other data

No numeric data

12.2 Length for age percentile (adjusted for breastfeeding status)

Other data

No numeric data

12.3 Weight for length percentile (adjusted for breastfeeding status)

Other data

No numeric data

13 Weight gain during pregnancy (kg) Show forest plot

1

87

Mean Difference (IV, Fixed, 95% CI)

‐1.20 [‐3.43, 1.03]

14 Adherence to dietary intervention Show forest plot

1

92

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.64, 1.11]

15 Insulin sensitivity: end of intervention: HOMA2‐IR (%) Show forest plot

1

77

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.38, 0.18]

16 Insulin sensitivity: end of intervention insulin (pmol/L) Show forest plot

1

70

Mean Difference (IV, Fixed, 95% CI)

10.80 [‐22.36, 43.96]

17 Use of additional pharmacotherapy Show forest plot

1

92

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.58, 1.17]

18 Glycaemic control: end of intervention blood glucose (mmol/L) Show forest plot

1

74

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.38, 0.18]

19 Glycaemic control: end of intervention HbA1c (%) Show forest plot

Other data

No numeric data

20 Return to pre‐pregnancy weight at 3 months postpartum Show forest plot

1

55

Risk Ratio (M‐H, Fixed, 95% CI)

1.15 [0.43, 3.07]

21 BMI at 3 months postpartum (kg/m²) Show forest plot

1

52

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐2.79, 1.79]

22 Impaired glucose tolerance at 3 months postpartum Show forest plot

1

58

Risk Ratio (M‐H, Fixed, 95% CI)

1.33 [0.44, 4.04]

23 Insulin sensitivity at 3 months postpartum (insulin (pmol/L)) Show forest plot

1

55

Mean Difference (IV, Fixed, 95% CI)

‐14.20 [‐32.58, 4.18]

24 Insulin sensitivity at 3 months postpartum (HOMA‐IR (%)) Show forest plot

1

53

Mean Difference (IV, Fixed, 95% CI)

‐0.30 [‐0.66, 0.06]

Figures and Tables -
Comparison 6. Low‐GI diet versus high‐fibre moderate‐GI diet
Comparison 7. Diet recommendation + diet‐related behavioural advice versus diet recommendation only

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

1

99

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.25, 2.14]

2 Caesarean section Show forest plot

1

99

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.38, 1.62]

3 Preterm birth (< 37 weeks' gestation) Show forest plot

1

99

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.10, 2.66]

4 Gestational weight gain: BMI at end of intervention (kg/m²) Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐1.75, 1.75]

5 Gestational weight gain: weight at end of intervention (kg) Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐4.91, 4.71]

6 Insulin sensitivity: end of intervention HOMA‐IR Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

‐0.30 [‐0.77, 0.17]

7 Insulin sensitivity: end of intervention fasting insulin (µU/mL) Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

‐0.5 [‐2.69, 1.69]

8 Use of additional pharmacotherapy Show forest plot

1

99

Risk Ratio (M‐H, Fixed, 95% CI)

0.61 [0.15, 2.42]

9 Glycaemic control: end of intervention fasting glucose (mg/dL) Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐4.25, 4.25]

10 Glycaemic control: end of intervention postprandial glucose (mg/dL) Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

‐9.30 [‐15.58, ‐3.02]

11 Glycaemic control: end of intervention HbA1c (%) Show forest plot

1

99

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.28, 0.08]

12 Length of postnatal stay (baby): stay > 4 days Show forest plot

1

99

Risk Ratio (M‐H, Fixed, 95% CI)

1.33 [0.73, 2.44]

Figures and Tables -
Comparison 7. Diet recommendation + diet‐related behavioural advice versus diet recommendation only
Comparison 8. Soy protein‐enriched diet versus no soy protein diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Hypertensive disorders of pregnancy: pre‐eclampsia Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

2.0 [0.19, 21.03]

2 Caesarean section Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.57, 1.77]

3 Gestational age at birth (weeks) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐0.23, 1.03]

4 Preterm birth (< 37 weeks' gestation) Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

2.0 [0.19, 21.03]

5 Macrosomia (> 4000 g) Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

0.6 [0.16, 2.31]

6 Birthweight (g) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐142.60 [‐360.40, 75.20]

7 Head circumference at birth (cm) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐1.01, 0.61]

8 Length at birth (cm) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐1.07, 0.87]

9 Neonatal hypoglycaemia Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.33, 27.42]

10 Neonatal hyperbilirubinaemia Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

0.27 [0.08, 0.89]

11 Gestational weight gain: BMI at end of intervention (kg/m²) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

0.60 [‐1.43, 2.63]

12 Gestational weight gain: weight at end of intervention (kg) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

3.50 [‐1.47, 8.47]

13 Insulin sensitivity: end of intervention HOMA‐IR Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐2.20, 0.20]

14 Insulin sensitivity: end of intervention QUICKI Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐0.01, 0.01]

15 Insulin sensitivity: end of intervention insulin (µIU/mL) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐2.60 [‐8.03, 2.83]

16 Use of additional pharmacotherapy Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.15, 6.70]

17 Glycaemic control: end of intervention fasting plasma glucose (mg/dL) Show forest plot

1

68

Mean Difference (IV, Fixed, 95% CI)

‐10.60 [‐15.37, ‐5.83]

18 Number of antenatal visits or admissions: maternal hospitalisation Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

0.75 [0.18, 3.10]

19 Neonatal intensive care unit admission: neonatal hospitalisations Show forest plot

1

68

Risk Ratio (M‐H, Fixed, 95% CI)

0.14 [0.02, 1.10]

Figures and Tables -
Comparison 8. Soy protein‐enriched diet versus no soy protein diet
Comparison 9. High‐fibre diet versus standard‐fibre diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gestational age at birth (weeks) Show forest plot

1

22

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐1.30, 1.30]

2 Birthweight (g) Show forest plot

1

22

Mean Difference (IV, Fixed, 95% CI)

‐94.0 [‐446.71, 258.71]

3 Gestational weight gain (kg) Show forest plot

1

22

Mean Difference (IV, Fixed, 95% CI)

2.40 [‐2.20, 7.00]

4 Use of additional pharmacotherapy Show forest plot

1

22

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Glycaemic control during/at end of intervention: mean blood glucose (mg/dL) Show forest plot

1

22

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐8.26, 8.26]

6 Maternal hypoglycaemia: mean number of events Show forest plot

1

22

Mean Difference (IV, Fixed, 95% CI)

‐1.0 [‐2.08, 0.08]

Figures and Tables -
Comparison 9. High‐fibre diet versus standard‐fibre diet
Comparison 10. Ethnic‐specific diet versus standard healthy diet

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Large‐for‐gestational age Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.14 [0.01, 2.45]

2 Neonatal composite outcome: hypoglycaemia, neonatal asphyxia, respiratory distress syndrome, and hyperbilirubinaemia, hypocalcaemia Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Hypertensive disorders of pregnancy: gestational hypertension Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.02, 7.32]

4 Caesarean section Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

1.2 [0.54, 2.67]

5 Gestational age at birth (weeks) Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

‐0.40 [‐1.15, 0.35]

6 Macrosomia (> 4000 g) Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.2 [0.01, 3.70]

7 Small‐for‐gestational age Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.02, 7.32]

8 Birthweight (g) Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

‐368.00 [‐928.87, 188.87]

9 Respiratory distress syndrome Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 Neonatal hypoglycaemia Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Neonatal hyperbilirubinaemia Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Neonatal hypocalcaemia Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Gestational weight gain (kg) Show forest plot

1

20

Mean Difference (IV, Fixed, 95% CI)

‐2.20 [‐7.24, 2.84]

14 Adherence to dietary intervention: good adherence Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

3.5 [0.95, 12.90]

15 Use of additional pharmacotherapy Show forest plot

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

2.0 [0.21, 18.69]

Figures and Tables -
Comparison 10. Ethnic‐specific diet versus standard healthy diet