Gestational diabetes & diabetes in pregnancy
Continuous Subcutaneous Infusion Versus Multiple Daily Injections of Insulin for Pregestational Diabetes in Pregnancy: A Systematic Review and Meta-Analysis
Authors' conclusion
Use of CSII (vs MDI) for pregestational DM in pregnancy is associated with higher odds of cesarean delivery and delivery of an LGA neonate. Further evaluation of how CSII use may influence neonatal size and delivery route is warranted.
Study context
- Population
- Pregnant persons with pregestational diabetes mellitus (DM); studies published 2010–2022
- Participants
- 5,518 pregnancies39 studies
- Comparison
- Continuous subcutaneous insulin infusion (CSII) vs MDI
- Outcome
- Cesarean delivery (primary maternal outcome) and neonatal hypoglycemia (primary neonatal outcome)
Methodological detailsrandom-effects models, librarian-assisted search
- Random-effects models
- Librarian-assisted search
Pooled result
As reported in the abstract
Cesarean delivery; neonatal hypoglycemia
CSII vs MDIOdds ratio (95% CI)
Cesarean delivery, 20 studies: 63%vs 56%; higher with CSII
1.3(1.2–1.5)
Neonatal hypoglycemia, 23 studies: 31%vs 34%; no difference identified
1.1(0.9–1.5)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| LGA neonate20 studies: 47%vs 38%; higher with CSII | 1.4 (1.2–1.6) | |
| 0.512Odds ratio (log scale) |
Large-for-gestational age (LGA) neonate
- Among secondary outcomes, only odds of LGA were higher with CSII vs MDI
Original publication
Continuous Subcutaneous Infusion Versus Multiple Daily Injections of Insulin for Pregestational Diabetes in Pregnancy: A Systematic Review and Meta-Analysis. J Diabetes Sci Technol. Published 4 August 2023. doi:10.
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