{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:42:04Z","timestamp":1793104924944,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T00:00:00Z","timestamp":1724544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The objective of this meta\u2010analysis 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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We 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\u2010effect model meta\u2010analyses were used to minimize the effects of uncertainty associated with inter\u2010study 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 <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The macrosomia (birthweight &gt;4000\u2009g) 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The macrosomia rate was lower in women managed with the FMIUFG. There were no significant differences in other obstetric and neonate outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.16059","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T05:54:27Z","timestamp":1724651667000},"page":"1759-1770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Gestational diabetes mellitus management according to ultrasound fetal growth versus strict glycemic treatment in singleton pregnancies: A systematic review and meta\u2010analysis of clinical trials"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4844-2145","authenticated-orcid":false,"given":"Ana M.","family":"Fern\u00e1ndez\u2010Alonso","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Torrec\u00e1rdenas University Hospital  Almer\u00eda Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5279-7013","authenticated-orcid":false,"given":"Ang\u00e9lica","family":"Monterrosa\u2010Blanco","sequence":"additional","affiliation":[{"name":"Women's Health Research Group University of Cartagena Faculty of Medicine  Cartagena Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0686-6468","authenticated-orcid":false,"given":"\u00c1lvaro","family":"Monterrosa\u2010Castro","sequence":"additional","affiliation":[{"name":"Women's Health Research Group University of Cartagena Faculty of Medicine  Cartagena Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2801-416X","authenticated-orcid":false,"given":"Faustino R.","family":"P\u00e9rez\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Arag\u00f3n Health Research Institute University of Zaragoza Faculty of Medicine  Zaragoza Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.112183"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43032-024-01514-x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21930"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1191-7"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.971745"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2019.10.003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2020.0078"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2544"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(15)00255-7"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2008.01.017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12291"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000899"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2307\/1164961"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_8_19_1","unstructured":"Sensitivity analyses.Cochrane Handbook 5.1. 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