Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes

Diane Farrar; Derek J Tuffnell; Jane West

doi:10.1002/14651858.CD005542.pub2

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Analysis 1.1

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 1 Rate of caesarean section.

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Analysis 1.2

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 2 Perinatal mortality.

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Analysis 1.3

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 3 Fetal anomaly.

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Analysis 1.4

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 4 Maternal hypoglycaemia.

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Analysis 1.5

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 5 Maternal hyperglycaemia.

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Analysis 1.6

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 6 Maternal 24 hour mean blood glucose (mg/dl) first trimester.

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Analysis 1.7

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 7 Macrosomia.

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Analysis 1.8

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 8 Gestation at delivery.

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Analysis 1.9

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 9 Neonatal hypoglycaemia.

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Analysis 1.10

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 10 Small‐for‐gestational age.

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Analysis 1.11

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 11 Mean HbA1c first trimester.

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Analysis 1.12

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 12 Mean HbA1c second trimester.

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Analysis 1.13

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 13 Mean HbA1c third trimester.

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Analysis 1.14

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 14 Mean birthweight.

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Analysis 1.15

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 15 Maternal 24 hour mean blood glucose (mg/dl) second trimester.

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Analysis 1.16

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 16 Maternal 24 hour mean blood glucose (mg/dl) third trimester.

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Analysis 1.17

Comparison 1 Continuous subcutaneous insulin infusion versus multiple daily injections, Outcome 17 days hospitalised.

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Comparison 1. Continuous subcutaneous insulin infusion versus multiple daily injections

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Rate of caesarean section Show forest plot	3	71	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.66, 1.77]

2 Perinatal mortality Show forest plot	3	71	Risk Ratio (M‐H, Fixed, 95% CI)	2.33 [0.38, 14.32]

3 Fetal anomaly Show forest plot	2	61	Risk Ratio (M‐H, Fixed, 95% CI)	1.07 [0.07, 15.54]

4 Maternal hypoglycaemia Show forest plot	2	61	Risk Ratio (M‐H, Fixed, 95% CI)	3.0 [0.35, 25.87]

5 Maternal hyperglycaemia Show forest plot	2	61	Risk Ratio (M‐H, Fixed, 95% CI)	7.0 [0.39, 125.44]

6 Maternal 24 hour mean blood glucose (mg/dl) first trimester Show forest plot	3	67	Mean Difference (IV, Fixed, 95% CI)	0.12 [‐7.19, 7.43]

7 Macrosomia Show forest plot	2	61	Risk Ratio (M‐H, Fixed, 95% CI)	3.2 [0.14, 72.62]

8 Gestation at delivery Show forest plot	3	71	Mean Difference (IV, Fixed, 95% CI)	‐1.18 [‐2.92, 0.57]

9 Neonatal hypoglycaemia Show forest plot	1	32	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.07, 14.64]

10 Small‐for‐gestational age Show forest plot	2	61	Risk Ratio (M‐H, Random, 95% CI)	1.40 [0.10, 18.71]

11 Mean HbA1c first trimester Show forest plot	1	32	Mean Difference (IV, Fixed, 95% CI)	‐0.20 [‐2.13, 1.73]

12 Mean HbA1c second trimester Show forest plot	1	32	Mean Difference (IV, Fixed, 95% CI)	0.70 [‐2.29, 3.69]

13 Mean HbA1c third trimester Show forest plot	1	32	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐2.38, 2.58]

14 Mean birthweight Show forest plot	2	61	Mean Difference (IV, Fixed, 95% CI)	220.56 [‐2.09, 443.20]

15 Maternal 24 hour mean blood glucose (mg/dl) second trimester Show forest plot	3	73	Mean Difference (IV, Fixed, 95% CI)	1.77 [‐5.02, 8.56]

16 Maternal 24 hour mean blood glucose (mg/dl) third trimester Show forest plot	3	69	Mean Difference (IV, Fixed, 95% CI)	0.08 [‐5.57, 5.72]

17 days hospitalised Show forest plot	1	10	Mean Difference (IV, Fixed, 95% CI)	9.40 [‐6.04, 24.84]

Comparison 1. Continuous subcutaneous insulin infusion versus multiple daily injections

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