Background
Methods/Design
Inclusion criteria
Search method
1. pregnan*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
2. exp Pregnancy/or exp Pregnancy Outcome/ |
3. antenatal.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
4. exp Prenatal Care/or exp Prenatal Diagnosis/ |
5. prenatal.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
6. exp Prenatal Nutritional Physiological Phenomena/or exp Prenatal Exposure Delayed Effects/ |
7. 1 or 2 or 3 or 4 or 5 or 6 |
8. neonatal.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
9. newborn*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
10. exp Infant, Newborn/ab, an, cl, co, di, et, gd, me, mi, mo, pa, pd, ph [Abnormalities, Analysis, Classification, Complications, Diagnosis, Etiology, Growth & Development, Metabolism, Microbiology, Mortality, Pathology, Pharmacology, Physiology] |
11. infan*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
12. exp Infant/ |
13. fetus.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
14. exp Fetus/ |
15. exp Fetal Development/ |
16. foetus.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
17. exp Fetus/ |
18. foetal*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
19. 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 |
20. 7 or 19 |
21. diabet*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
22. exp Diabetes Mellitus, Type 2/or exp Diabetes Complications/or exp Diabetes Mellitus/ |
23. 21 or 22 |
24. hyperglyc?mi*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
25. exp Hyperglycemia/ |
26. glucose intoleran*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
27. exp Glucose Intolerance/or exp Glucose Tolerance Test/ |
28. obes*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
29. exp Obesity/ |
30. 24 or 25 or 26 or 27 or 28 or 29 |
31. 23 or 30 |
32. gestational diabet*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
33. exp Diabetes, Gestational/ |
34. 32 or 33 |
35. aborigin*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
36. exp Indians, North American/or exp Oceanic Ancestry Group/ |
37. indigen*.mp. [mp = title, original title, abstract, name of substance word, subject heading word, unique identifier] |
38. exp Health Services, Indigenous/ |
39. 35 or 36 or 37 or 38 |
40. 20 and 31 |
41. 34 or 40 |
42. 39 and 41 |
43. 31 and 39 |
44. 20 and 39 |
45. native*.mp. or exp American Native Continental Ancestry Group/ |
46. (45 and 41) not 39 |
Data collection
Data extraction
Research purpose | Study design |
---|---|
Descriptive
|
Descriptive (cross-sectional survey or qualitative study) or analytical (cohort study, case-control study or cross-sectional study with control group) |
Intervention
|
Experimental (control group) or other
|
Measurement
| Screening test efficacy studies |
Other
| Reviews, opinions, guidelines, etc. |
Appraisal of external validity (generalisability)
Appraisal of internal validity (risk for bias)
Type of risk | Low | Moderate | High |
---|---|---|---|
Selection (sampling of population)
| Consecutive unselected population Sample from general population not a selected group Rationale for case and control selection explained Follow-up or assessment time appropriate | Sample selected from large population, but selection criteria not defined Sample selection ambiguous, but may be representative Eligibility criteria not described Rationale for case and control selection not described Follow-up assessment not appropriate Analysis to adjust for sampling strategy bias | Sample selection ambiguous, and sample unlikely to be representative Highly selected population, making it difficult to generalise findings |
Selection (sampling size) if non-significant results; otherwise NA
| Sample size calculation conducted and adequate | Sample size calculation not performed, but all eligible persons studied Sample size calculation performed, and reasons for not meeting sample size given | Sample size estimation unclear or only subsample studied |
Selection (participation rate)
| High participation rate (> 85%) | Moderate participation rate (70-85%) | Low participation rate (> 70%) |
Performance bias (outcome assessment)
| Diagnosis on basis of consistent criteria and direct examination | Assessment from hospital record or by questioning person Assessment from administrative database or register | Assessment from non-validated data or generic estimate from overall population |
Performance bias (confounding factors)
| Control for common confounders (e.g. risk factors) | Only certain confounders adjusted (e.g. age) | Not controlled for any confounders |
Performance bias (blinding) when outcome and exposure relations being assessed (e.g. effect of GDM on offspring)
| Outcome and exposure assessment independently blinded | Outcome and exposure assessment independently blinded | |
Performance bias (methods to control for bias)
| Analysis appropriate for type of sample (e.g. subgroup analysis/regression etc.) | Analysis did not account for common adjustment | Data confusing |
Attrition bias
| 0-10% attrition All participants from initiation to final outcome assessment accounted for Sensitivity analysis conducted for missing data | 11-20% attrition No sensitivity analysis for missing data | > 20% attrition and no sensitivity analysis for missing data |
Other: for comparative studies
| Comparison groups similar at baseline | Baseline characteristics of comparison groups not assessed | Baseline characteristics dissimilar |
Data analysis
GRADE symbol | Level of confidence in quality of evidence | Definition | Criteria |
---|---|---|---|
⊕ ⊕ ⊕ ⊕ |
High
| We are confident the true effect lies close to the estimate of the effect. | One or more studies were appraised at low risk of bias. |
⊕ ⊕ ⊕ |
Moderate
| We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. | No studies were appraised at low risk of bias, although one or more studies were appraised at moderate risk of bias. |
⊕ ⊕ |
Low
| Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. | No studies were appraised as low or moderate risk of bias. One or more studies were appraised at high risk of bias. |
⊕ |
Very low
| We have very little confidence in the effect estimate. | The publications were not in a format that allowed appraisal of the effect estimate (e.g. opinion piece). |