Evidence map›Paper›PMID 41354939›Full record

SynthesisDiabetic medicine : a journal of the British Diabetic Association2026

Associations of modifiable preconception, pregnancy and postpartum factors with health outcomes for women with type 2 diabetes and their children: A systematic review and meta-analysis of observational studies.

Danielle Schoenaker, Eleanor Dyer, Nicola Heslehurst, Grainne Kent, Sowmiya Gunabalasingam, Lily Hopkins, Artemis Kyrka, Rivka Lebrett, Angela C Flynn, Sara L White and 2 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Diabetic medicine : a journal of the British Diabetic Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Danielle SchoenakerSchool of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.ORCID https://orcid.org/0000-0002-7652-990X
Eleanor DyerPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID https://orcid.org/0000-0002-4797-1459
Nicola HeslehurstPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Grainne KentSchool of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
Sowmiya GunabalasingamDepartment of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.
Lily HopkinsDepartment of non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Artemis KyrkaDepartment of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.
Rivka LebrettDepartment of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.
Angela C FlynnSchool of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
Sara L WhiteDepartment of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK.
Claire L MeekLeicester Diabetes Centre and Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.ORCID https://orcid.org/0000-0002-4176-8329
Rita FordeFaculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.

Funding

Diabetes UKEuropean Foundation for the Study of DiabetesMedical Research CouncilNational Institute for Health and Care Research
6 · The paper itself

Abstract

aimType 2 diabetes (T2D) in pregnancy is increasingly common and associated with suboptimal outcomes for these women and their children. We aimed to synthesize observational evidence on associations of modifiable preconception, pregnancy and postpartum risk factors with perinatal outcomes among women with pregestational T2D.

methodsSearches were conducted in six databases (September 2023). Observational studies among women with pregestational T2D were included if they reported associations of modifiable risk factors with maternal and/or child outcomes. Screening, data extraction and quality assessments were conducted by two reviewers. Findings were synthesized through random effects meta-analysis or narrative synthesis when results were too few or heterogeneous to pool.

resultsSearches identified 15,578 results; 58 studies were included. Meta-analysis showed excessive gestational weight gain (GWG) was associated with large for gestational age (LGA) (OR 2.39, 95%CI 1.74-3.29) but not small for gestational age (SGA). Meta-analysis demonstrated no associations between preconception care or metformin use with adverse pregnancy, birth and neonatal outcomes. However, narrative synthesis showed preconception care was associated with increased use of folic acid and vitamin D, and reduced GWG. Further narrative synthesis findings showed that higher BMI was associated with multiple suboptimal pregnancy, birth and neonatal outcomes. Excessive GWG was associated with increased insulin requirements and increased likelihood of neonatal hypoglycaemia. The use of metformin/oral hypoglycaemic medications was associated with reduced GWG and fewer caesarean deliveries. There was mixed or no evidence of association for other reported exposures and outcomes.

conclusionBased on observational evidence, increasing access to preconception care could be beneficial to optimize maternal nutrition and weight-related outcomes, and addressing obesity and GWG has the potential to improve maternal and neonatal outcomes in pregnancies affected by T2D.

Indexed as

Diabetes Mellitus, Type 2Postpartum PeriodPreconception CarePregnancy in DiabeticsFemaleGestational Weight GainHumansInfant, NewbornObservational Studies as TopicPregnancyPregnancy OutcomeRisk Factorsperinatalpostpartumpreconceptionpregnancyreproductive healthtype 2 diabeteswomen's health

Identifiers

PMID41354939
PMCPMC12857875

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.