Table 1_Long-term metabolic consequences of in-utero gestational diabetes exposure and maternal treatment interventions: a systematic review and meta-analysis.docx

All meta-analyses used the random-effects inverse-variance model. Heterogeneity was assessed via I² and Cochran’s Q statistic, and Egger’s linear regression test was used to detect publication bias.</p>Results<p>Sixteen studies (n=9 RCTs, n=7 observational cohorts) involving diverse populations across 11 countries were included. In observational cohorts, GDM-exposed offspring showed higher BMI (MD = 1.42 kg/m2, 95% CI: 0.94-1.89) and greater estimates for overweight/obesity in adulthood (OR = 2.09, 95% CI: 1.25–3.50, I² = 80.7%).

The analysis of fasting glucose results displayed high variability (I² = 80.7%) yet produced no meaningful combined impact (MD = -0.016 mmol/L, 95% CI: -1.52 to 1.49). In RCTs, active antenatal GDM management was associated with a non-significant trend towards lower HOMA-IR (MD = -0.30, 95% CI: -0.61 to 0.01; I² = 68.2%) and HbA1c (MD = -0.41%, 95% CI: -0.85 to 0.03; I² = 99.1%) relative to usual care. There were no statistically significant combined effects found for 2-hour OGTT glucose levels total cholesterol levels triglyceride levels or HDL-C levels.

Egger’s test revealed no significant publication bias for either glucose (t = 0.82, p = 0.43) or lipid outcomes (t = -0.08, p = 0.94).</p>Conclusion<p>In-utero GDM exposure confers metabolic risks from childhood to adulthood; lifelong persistence requires verification via extended longitudinal research GDM interventions including diet, exercise and pharmacotherapy may lower offspring risk, although heterogeneity necessitates cautious interpretation.</p>