AIMS Several interventions have been implemented to prevent the development of gestational diabetes mellitus (GDM) in obese pregnant women, including physical exercise programs, and administration of metformin, vitamin D and probiotics. The aim of this network meta-analysis was to compare the efficiency of these interventions and identify the optimal. MATERIALS A network meta-analysis of randomized trials was performed comparing the different interventions for the development of GDM in overweight or obese women, either to each other or placebo/no intervention. A search was conducted in four electronic databases and grey literature sources. The primary outcome was the development of GDM; secondary outcomes were other complications of pregnancy. RESULTS The meta-analysis included 23 studies (4237 participants). None of the interventions was superior compared with placebo/no intervention for the prevention of GDM. Metformin and physical exercise were superior to placebo/no intervention for gestational weight gain (MD -1.21, 95% CI -2.14 to -0.28 and MD -0.96, 95% CI -1.69 to -0.22, respectively). Metformin was superior to placebo/no intervention for caesarean sections and admission to NICU. CONCLUSIONS Interventions aiming to prevent the development of GDM in overweight/obese women are not effective, when applied during pregnancy.

中文翻译：

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预防超重或肥胖孕妇的妊娠糖尿病：网络荟萃分析。

目的已采取多种干预措施来预防肥胖孕妇的妊娠糖尿病（GDM）的发展，包括体育锻炼计划以及二甲双胍，维生素D和益生菌的管理。该网络荟萃分析的目的是比较这些干预措施的效率并确定最佳干预措施。材料进行了一项随机试验的网络荟萃分析，比较了超重或肥胖女性中GDM发生的不同干预措施之间的相互干预或安慰剂/无干预措施。在四个电子数据库和灰色文献来源中进行了搜索。主要结果是GDM的发展。次要结果是妊娠的其他并发症。结果荟萃分析包括23项研究（4237名参与者）。与安慰剂/无干预措施相比，没有任何一种干预措施能预防GDM。二甲双胍和体育锻炼在妊娠期体重增加方面优于安慰剂/无干预措施（分别为MD -1.21，95％CI -2.14至-0.28和MD -0.96，95％CI -1.69至-0.22）。二甲双胍在剖宫产和重症监护病房（NICU）方面优于安慰剂/无需干预。结论在怀孕期间应用旨在防止超重/肥胖妇女GDM发展的干预措施无效。二甲双胍在剖宫产和重症监护病房（NICU）方面优于安慰剂/无需干预。结论在怀孕期间应用旨在防止超重/肥胖妇女GDM发展的干预措施无效。二甲双胍在剖宫产和重症监护病房（NICU）方面优于安慰剂/无需干预。结论在怀孕期间应用旨在防止超重/肥胖妇女GDM发展的干预措施无效。