000145117 001__ 145117 000145117 005__ 20240926122722.0 000145117 0247_ $$2doi$$a10.1111/jog.16059 000145117 0248_ $$2sideral$$a139922 000145117 037__ $$aART-2024-139922 000145117 041__ $$aeng 000145117 100__ $$aFernández-Alonso, Ana M. 000145117 245__ $$aGestational diabetes mellitus management according to ultrasound fetal growth versus strict glycemic treatment in singleton pregnancies: A systematic review and meta-analysis of clinical trials 000145117 260__ $$c2024 000145117 5060_ $$aAccess copy available to the general public$$fUnrestricted 000145117 5203_ $$aAbstractAimThe objective of this meta‐analysis was to evaluate obstetric outcomes in gestational diabetes mellitus (GDM) patients treated with flexible management based on intrauterine ultrasound fetal growth (FMIUFG) or strict maternal glycemic adjustment (SMGA).MethodsWe performed a comprehensive systematic review of electronic databases for randomized clinical trials (RCTs) comparing obstetrics outcomes of singleton GDM patients managed according to FMIUFG or SMGA. The review protocol was registered in PROSPERO (CRD497888). Searches were conducted in PubMed, Embase, Cochrane, and LILACS. Primary outcomes were gestational age at delivery and birth weight. Random‐effect model meta‐analyses were used to minimize the effects of uncertainty associated with inter‐study variability. Results are reported as standardized mean differences (SMDs) or as odds ratios (ORs) and their 95% confidence interval (CI). Heterogeneity between studies was estimated using the I2 statistic. The Cochrane Risk of Bias Scale was used to assess the quality of studies. There were five RCTs with low to moderate risk of bias, including 450 patients managed according to the FMIUFSG and 381 according to the SMGA.ResultsThe macrosomia (birthweight >4000 g) rate was lower in pregnancies managed according to FMIUFG than SMGA adjustments (OR: 0.34; 95%CI: 0.16, 0.71). There were no significant differences in hypertensive disorder, cesarean section, neonatal intensive care unit admission, and large newborn for gestational age rates.ConclusionsThe macrosomia rate was lower in women managed with the FMIUFG. There were no significant differences in other obstetric and neonate outcomes. 000145117 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/ 000145117 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000145117 700__ $$aMonterrosa-Blanco, Angélica 000145117 700__ $$aMonterrosa-Castro, Álvaro 000145117 700__ $$0(orcid)0000-0002-2801-416X$$aPérez-López, Faustino R. 000145117 773__ $$g(2024), 12 pp.$$pJ. obstet. gynaecol. res.$$tThe journal of obstetrics and gynaecology research$$x1341-8076 000145117 8564_ $$s2452285$$uhttps://zaguan.unizar.es/record/145117/files/texto_completo.pdf$$yVersión publicada 000145117 8564_ $$s2390024$$uhttps://zaguan.unizar.es/record/145117/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000145117 909CO $$ooai:zaguan.unizar.es:145117$$particulos$$pdriver 000145117 951__ $$a2024-09-26-10:59:49 000145117 980__ $$aARTICLE