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Self-care interventions among women with gestational diabetes mellitus in low and middle-income countries: a scoping review

Systematic Reviews volume 14, Article number: 50 (2025) Cite this article

Abstract

Background

Gestational diabetes mellitus (GDM) is a transitory form of diabetes occurring in pregnancy with maternal and neonatal health consequences if left untreated. GDM can, in most instances, be managed non-medically through self-care practices, such as eating healthy or engaging in physical activity. This is especially relevant in a global health context with scarce resources. There is no official definition of “GDM self-care”; hence, the content and delivery modes of such interventions may vary greatly. Therefore, this study aimed to landscape GDM self-care interventions in low- and middle-income countries according to the WHO's three dimensions of health.

Methods

PubMed, Embase, Global Health Library, and Web of Science were searched for published intervention studies that compared the effect of a self-care intervention to standard care or had no comparator. Studies that targeted women with GDM that reported maternal health and/or neonatal health outcomes (physical, mental, and social health outcomes) and were conducted in low- and middle-income countries were included in the review.

Results

Twenty-nine studies (randomised controlled trials and non-randomised studies) were included in the review. No studies were conducted in low-income countries, and studies were primarily conducted in Asia. Most interventions were complex and contained several interacting elements in relation to content, delivery mode, duration, and modality. Most interventions aimed to improve the physical health dimension (n = 28; 96.6%), whilst the mental health (n = 11; 37.9%) and social health dimensions (n = 9; 31.0%) were addressed to a lesser extent.

Conclusions

Current GDM self-care interventions in LMICs are complex, and the content of self-care interventions overlaps with lifestyle and non-pharmaceutical interventions. It is recommended that the scientific community use a standardised terminology for such interventions and that future GDM intervention studies, as a minimum, use the core outcome set for GDM when developing future studies.

Systematic review registration

OSF Registries (2 December 2022) [https://doiorg.publicaciones.saludcastillayleon.es/10.17605/OSF.IO/PJZQ3].

Peer Review reports

Background

Diabetes is a major contributor to the global rise in non-communicable diseases [1, 2]. Gestational diabetes mellitus (GDM) is a transitory form of diabetes that presents during pregnancy, and it is a rising global health issue. If GDM is not managed, it can have short-term health consequences for both the mother and the unborn child, such as high blood pressure, pre-eclampsia, preterm birth, caesarean section (c-section), macrosomia, stillbirth, and mental health issues [3,4,5,6,7,8]. Further, it can have long-term health consequences, such as increased risk of obesity, cardiovascular disease, and type 2 diabetes (T2D) for both mother and child [9,10,11,12,13]. GDM can be identified through universal or risk-based screening in pregnancy, after which healthcare providers need to guide pregnant woman and their families on how to control the condition. Most often, the disease can be managed non-medically, e.g. through self-care activities such as physical exercise or diet change [14,15,16].

The World Health Organization (WHO) emphasises the importance of locally grounded, informal self-care interventions for global diabetes management [17]. According to the WHO, self-care is “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker” [18], and it is a significant component of people-centred primary health care [18]. However, to the best of our knowledge, there is no official definition of what self-care among pregnant women specifically involves, and little is known about how the different elements of self-care interventions among women with GDM in low- and middle-income countries (LMICs) address the physical, mental and social health dimensions related to GDM. For future studies to develop effective self-care interventions among pregnant women with GDM in LMICs, an overview of the literature is needed.

Aim

This study aims to provide an overview of the content of self-care interventions among pregnant women with GDM in LMICs.

Methods

Protocol and registration

This protocol-driven scoping review has been registered in the OSF registries: https://doiorg.publicaciones.saludcastillayleon.es/https://doiorg.publicaciones.saludcastillayleon.es/10.17605/OSF.IO/SVU7G. The protocol was developed according to the PRISMA-SCR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Extension for Scoping Review) checklist [19]. The manuscript is reported according to the PRISMA checklist (Additional file 1).

Information sources

Block search strings (Additional file 2) were developed in cooperation with a scientific librarian, and four scientific databases (PubMed, Embase, Global Health Library, Web of Science) were searched from inception to 25 May 2024. The following versions of the databases were searched: Embase [Classic + Embase 1947], Global Health Library [Core collection; From 1973], and Web of Science [Core collection; From 1900). PubMed was searched using its primary database, and no alternative versions exist.

Criteria for considering studies for this review

In this review, the standard core elements of a scoping review (Population, Concept, and Context) were interpreted according to the PICO-SD criteria (Population, Intervention, Comparator, Outcome, Setting, study Design), and studies were included accordingly:

Population

We included studies with a study population of pregnant women diagnosed with GDM. We excluded studies that targeted healthcare providers and family members of pregnant women diagnosed with GDM.

Intervention

We included studies with self-care interventions or studies with a combined self-care and medical management intervention which contained elements of the three dimensions of health according to the WHO definition:

  • Self-care interventions focused on improving physical health, i.e. pregnancy-related risk factors, such as healthy diet and physical activity.

  • Self-care interventions focused on improving mental health, i.e. personal well-being, depression, quality of life (QoL), and anxiety.

  • Self-care interventions focused on improving social health, i.e. social support from friends and family as well as informal access to medical staff.

We included all types of self-care interventions, including psycho-social, counselling, empowerment-based, health education, and advocacy interventions, and had no limitations to the content, format (digital, printed, interactive) or length of the intervention. Hence, the content of the self-care interventions could vary greatly depending on which type of health dimension it contained, and which specific health outcome it aimed to improve. For example, the content of self-care interventions that aimed to improve physical health could contain education or counselling for healthy diets or exercising; self-care interventions that aimed to improve mental health could entail anxiety reduction techniques or relaxation methods, whilst self-care interventions with social health dimensions could entail social network support or informal access to healthcare personnel.

Comparator

We included studies that compared the self-care GDM intervention to standard GDM care or had no comparator.

Outcome

We included studies that reported maternal and/or neonatal health outcomes according to WHO's three dimensions of health. For example, physical health outcomes included weight, hyper and hypo-glycaemia, proteinuria, blood pressure, c-section, prolonged labour, episiotomy, use of oxytocin, birthweight, blood glucose, stillbirths, pre- and post-mature births, macrosomia; mental health outcomes included postpartum depression and stress, and social health outcomes included patient satisfaction and social support. There were no restrictions on how outcomes should be measured/assessment tools, e.g. outcomes could be self-reported questionnaires (multiple-choice, binary questions, scales), checklists, pregnancy records, birth records, daily self-monitoring blood glucose (SMBG) records, blood samples, exercise records, gestational weight gain, postpartum weight reports, etc.

Setting

We included studies that were set in LMICs according to the World Bank’s definition. The World Bank assigns the world’s economies into four income groups—low, lower-middle, upper-middle, and high income, and we included studies that were set in low, lower-middle, and upper-middle-income countries [20] (Additional file 3).

Design

We included all types of intervention studies, e.g. randomised controlled trials (RCT), quasi-experimental studies, and pre-post-intervention studies. We excluded reviews, protocols, editorial and conference abstracts as well as non-English articles.

Selection of studies

All citations were imported into Covidence, after which duplicates were removed. Two authors (PCG/DTNA) independently screened titles and abstracts according to the inclusion criteria. Full-text papers were sought for all citations that met the inclusion criteria after the title-abstract screening, after which two authors independently full-text screened the papers (PCG/HLM). Disagreement regarding inclusion was resolved by discussion, and if an agreement could not be reached, an arbiter (DSL) made the final decision. Reasons for excluding articles were recorded.

Data extraction

An Excel template was used for data extraction. Four authors conducted the data extraction (PCG/NDK/AN/DTNA). The following data was extracted: Author, journal, publication year, objective, design, inclusion/exclusion criteria, definition of self-care, study period, study population, age, intervention, comparator, length of follow-up, outcome, and trial registration when relevant.

Data synthesis

A critical appraisal of the included studies was not conducted; however, a narrative analysis of all studies was performed. In particular, the content and delivery mode of the self-care interventions were described, how different outcomes were reported, and how the interventions addressed maternal and neonatal physical, mental, or social health according to WHO’s three dimensions of health.

Quality appraisal

No quality appraisal was conducted in line with the guidelines for scoping reviews [21].

Results

A total of 3237 citations were found in the scientific databases, and 3 were found through citation searching. These were imported to Covidence, where 2215 duplicates were removed. Thus, 1025 citations were title-abstract screened, and 962 were excluded, resulting in 63 citations being sought for retrieval for full-text screening. However, six could not be retrieved via the university libraries and were therefore excluded. A total of 57 articles were full-text screened, and 29 were included in the review (see Fig. 1).

Fig. 1
figure 1

PRISMA flow chart

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Characteristics of the included studies

The characteristics of the studies are summarised in Table 1. All included studies were published from 2012 onward, with the majority of studies (n = 17) published between 2019 and 2024. Studies were primarily (82.8%) set in Asia, specifically in China (n = 9) [22,23,24,25,26,27,28,29,30], Iran (n = 8) [31,32,33,34,35,36,37,38], and India (n = 5) [13, 39,40,41,42]. In addition, a multi-country study was conducted in India, Sri Lanka, and Bangladesh [43], and another was conducted in Thailand [44]. Further, only 7% were set in North Africa, specifically Egypt [45] and Tunisia [46], and in Europe, specifically Turkey (n = 2) [47, 48]. Finally, one study (3.4%) was conducted in South America, specifically Brazil [49]. There were no studies conducted in low-income countries, while 16 studies were conducted in lower-middle-income countries, including Iran [31,32,33,34,35,36,37,38], India [13, 39,40,41,42,43], Egypt [45], and Tunisia [46]. The 13 remaining studies were set in upper-middle-income countries, including China [22,23,24,25,26,27,28,29,30], Turkey [47, 48], Thailand [44], and Brazil [49] (Table 1 and Fig. 2).

Table 1 Characteristics of included studies
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Fig. 2
figure 2

Heat map: geographic distribution of reviewed studies

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A total of 7391 pregnant women were enrolled in the studies. The mean age among the participants ranged from 26.8 to 34 years, whilst four studies reported age intervals between 20–40 years [39, 40], 20–45 years [46], and 18–45 years [48]. Further, one study did not report the age of participants [31] (Table 1).

The vast majority of studies were RCTs (n = 24) [22,23,24,25,26,27,28,29,30,31,32,33,34,35, 37, 38, 40, 43,44,45,46,47,48,49], whilst five studies were non-randomised intervention studies [13, 36, 39, 41, 42], of which three were pilot intervention studies [36, 39, 41]. The majority of studies compared the intervention to standard care (n = 26), whilst three studies had no comparator. However, the standard care encompassed varied considerably across studies (Table 1 and Additional file 4).

Characteristics of the self-care interventions

The WHO health dimensions

Table 2 shows the classification of Self-Care Interventions by WHO Health Dimensions. The majority of studies (96.6%) aimed to improve the physical health dimension—51.7% focused solely on the physical health dimension [13, 22, 24,25,26, 29, 30, 32, 34, 37, 40,41,42, 45, 49] whilst approximately one-third of self-care interventions were designed to address two health dimensions, i.e. physical health and mental health (n = 5) [27, 38, 39, 44, 47], physical health and social health (n = 3) [23, 28, 46], or mental health and social health (n = 1) [35]. Five studies addressed all three health dimensions [31, 33, 36, 43, 48].

Table 2 Classification of self-care interventions according to WHO health dimensions
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Interventions aimed to enhance physical health through various individual self-care modifications, mainly dietary modification (n = 25; 86.2%), physical activities—such as diaphragmatic breathing, aerobic or resistance exercises—or exercises combined (n = 22; 75.9%), self-monitoring of blood glucose (SMBG) (n = 16; 55.2%) or medication/insulin therapy if needed (n = 12; 41.4%). Further, some interventions focused on weight management (n = 6; 20.7%) or postpartum care/management (n = 5; 17.2%), whilst two studies concerned foot care [34, 36]. Overall, most interventions were complex (23 out of 28) and integrated at least two individual self-care behaviours to improve physical health. However, three RCTs focused solely on nutrition supplements [26, 37, 49], and two focused on yoga or breathing exercises [39, 47] (Table 2).

Overall, eleven studies contained self-care interventions that aimed to improve mental health, and stress management was the most common focus area [27, 31, 33, 35, 36, 38, 39, 47], followed by psychological counselling, mindfulness and relaxation techniques, such as meditation (13.8%) or breathing exercises (13.8%). Further, problem-solving was addressed in one study [35] and one aimed to improve quality of life [38].

The social health dimension was an integrated element in nine studies, and eight interventions contained peer support or group discussions [28, 31, 33, 35, 36, 43, 46, 48], while one study contained couple support [23].

Delivery modes

A wide variety of intervention delivery modes were used across the studies. Face-to-face individual education or a behaviour counselling approach was the most common delivery mode—either as a stand-alone approach (n = 8) [22, 26, 39, 40, 42, 45, 47, 49] or combined with other delivery modes (n = 14) [13, 24, 25, 27,28,29,30,31, 36, 37, 41, 43, 44, 46]. Further, approximately 55% of studies had a digital element incorporated into the intervention, and the dominant digital mode was phone calls/messages (n = 11) [24, 25, 29, 32,33,34, 36, 37, 41, 43, 48], WeChat (n = 5) [23, 24, 27,28,29], and mobile applications such as WhatsApp, HOMA software, and a web-based mobile application (n = 3) [31, 33, 48]. Additionally, six studies utilised video/movie tutorials in the intervention [27, 33, 36, 41, 44, 48] (Table 1 and Additional file 4).

Printed educational materials were also widely used (52%), e.g. booklets (n = 5) [13, 31, 34, 38, 40], handbooks/guidebooks (n = 5) [25, 26, 29, 33, 42], manuals (n = 2) [27, 44], tailored daily menu, pamphlets, or brochures (n = 3) [25, 36, 47]. Almost 70% of the studies required that the participants self-practiced or self-recorded at home [13, 22,23,24,25, 27,28,29,30,31, 33, 36, 37, 39, 41, 42, 44, 46,47,48] and provided a logbook, a written or digital diet tracking sheet or a self-monitoring tool [13, 23,24,25, 27,28,29, 31, 33, 36, 37, 41, 42, 46,47,48]. In addition, four interventions also provided a free glucometer or a continuous glucose monitoring system (CGMS) [30, 46, 47, 49], a pedometer [13, 42], or a blood pressure monitor [47] (Table 1 and Additional file 4).

Intensity, modality, and duration

The intensity and modality of the interventions varied widely (Table 1 and Additional file 4). The intensity ranged from a single session [24, 29, 41, 42, 47, 49], 2–3 sessions [27, 33, 36, 37, 44, 45], and up to four or more sessions [13, 22, 23, 25, 26, 28, 30,31,32, 34, 35, 38,39,40, 43, 46, 48] each lasting from 30 to 120 min.

Additionally, the delivery setting and the providers involved in the interventions varied. Approximately 90% of the studies implemented the intervention in a healthcare setting, but nearly 50% also integrated a home-based/remote counselling/education element. Nine studies had a multidisciplinary staff team to provide health education/behaviour counselling [13, 24, 27, 29, 30, 42, 43, 46, 48], whilst approximately 52% employed a single provider to provide self-care counselling/education. Further, 10 studies utilised a researcher or instructor [23, 28, 31, 33,34,35,36, 39, 41, 47], three studies used a nutritionist or dietitian [25, 26, 37], and two involved a physician [22, 45]. Five studies did not specify who provided the self-care counselling for the intervention [32, 38, 40, 44, 49] (Table 1 and Additional file 4).

The duration of follow-up ranged from 10 days to 3 years postpartum (Table 1), with the majority of studies (62%) following up pregnant women/new mothers between 2.5 and 12 months [13, 23, 25,26,27,28,29,30,31,32, 34, 40,41,42,43, 45, 46, 48], or between 0.5 and 2 months (31.0%) [24, 33, 35,36,37,38, 44, 47, 49]. The median duration of follow-up was 3 months, and only one study had a follow-up duration of 1–3 years postpartum [22].

Outcomes

The overall outcomes, outcome measures, and outcomes reporting varied widely across studies (Table 3 and Additional file 5).

Table 3 Type of primary outcomes
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Learning outcomes

Learning outcomes were assessed using two indicators: self-efficacy (confidence in self-management) and women’s GDM knowledge and beliefs. One study measured self-efficacy through an 8-item questionnaire scored on a Likert scale from 1 to 10, where 1 indicated “I am not sure at all” and 10 meant “I am quite sure.” The scores ranged from 8 to 80 [33]. Two studies evaluated the effect of the interventions on GDM knowledge [45, 48] (Table 3 and Additional file 5).

Behavioural outcomes

Eleven studies examined self-care behavioural outcomes, including various diets, physical activities, self-monitoring of blood glucose (SMBG), or problem-solving/coping [23, 24, 27, 31, 35, 36, 38, 39, 42, 45, 48]. Four studies combined various self-care behaviours [23, 31, 38, 48], whilst three studies evaluated a single self-care behaviour, such as physical activity [24, 42] or problem-solving/coping scores [35]. For example, Rafie et al. [35] measured the difference in problem-solving/coping for stressful situations between the intervention and control, whilst another measured changes in daily step count and the intensity of activities post-intervention [42]. Further, another study measured the mean exercise time in the intervention group [24], whilst another study assessed the breastfeeding rate between the two groups [45] (Table 3 and Additional file 5).

Mental health outcomes included stress, anxiety, depression, and Quality of Life (QoL). One study used the Perceived Stress Scale (PSS) to measure stress reduction [39], whilst another used the Self-Rating Depression Scale (SAS) and the Self-Rating Anxiety Scale (SDS) [27] to assess changes in anxiety and depression. Four studies measured QoL using different metrics, including the WHOQOL-BREF questionnaire [38], the Flanagan QoL scale [39], the Diabetes QoL questionnaire [36], and the QoL gravidarum (QOL-GRAV) [31].

Clinical outcomes

Clinical outcomes were the most common type of outcome, as reported in 27 of 29 studies. Several different clinical outcomes were reported, including fasting blood glucose (FBG), 1-h postprandial blood glucose (1 h-PBG), 2-h postprandial blood glucose (2 h-PBG), glycated haemoglobin (HbA1c), oral glucose tolerance tests (OGTT), hypoglycaemia, blood pressure (BP), heart rate, respiration rate, lipid indexes, amniotic fluid index, hospitalisation duration, and other maternal and neonatal outcomes. The most frequent clinical outcomes were glycaemic parameters, with 19 studies monitoring FBG alone or combined with 1-h or 2-h PBG [24, 26,27,28, 32, 33, 36,37,38,39,40,41,42,43,44, 46,47,48,49]. Changes in weight were reported in four studies (25, 27, 37, 45], and three studies addressed gestational weight gain [27, 37, 45], whilst one study reported weight loss after 1 year [25]. Other maternal clinical outcomes included cardio-metabolic risk parameters, such as heart rate and lipid indexes [39, 40, 47], complications or hospitalisation due to GDM and c-sections [13, 22, 27, 29, 34, 41, 46]. Further, neonatal outcomes were assessed solely or in addition to maternal outcomes in seven studies. Birthweight/macrosomia was measured in four studies [13, 22, 30, 34], and the preterm delivery rate was assessed in three studies [22, 27, 34]. Further, three studies assessed adverse neonatal outcomes [27, 29, 42], and two studies measured neonatal hypoglycaemia [13, 27] (Table 3 and Additional file 5).

Other outcomes

In addition to the learning, behavioural and clinical outcomes, nurse or patient satisfaction was an outcome in two studies [27, 48] (Table 3 and Additional file 5).

Discussion

Key findings

This review provides an overview of GDM self-care intervention studies in low- and middle-income countries. We found that self-care primarily addresses physical health aspects, whilst the mental health and social health dimensions were addressed to a lesser extent. Overall, most interventions were complex and included several different interacting elements, and the content, duration, mode of delivery, follow-up time, and outcomes were heterogeneous across studies. Most studies were conducted in Asia, and none in low-income countries.

Comparison with other literature

A 2022 systematic review assessed the effect of “non-pharmacological community GDM interventions” compared to placebo and usual care [51], whilst a 2017 Cochrane review on “lifestyle interventions” assessed maternal physical and mental health as well as neonatal health [52]. In contrast to our review, the 2022 review also included healthcare-administered interventions and studies from high-income countries and solely focused on physical health outcomes, whilst the Cochrane review primarily included studies from high-income countries and assessed physical and mental health outcomes but not social health outcomes. It appears that there may be a remarkable overlap between the concepts “self-care intervention”, “non-pharmacological community interventions”, and “lifestyle interventions as non-pharmacological intervention contained self-care programs that aimed to improve self-efficacy, lifestyle behaviours and BG control through education and support as well as exercise activities, diet therapy, and continuous glucose monitoring [51] whilst “lifestyle interventions" contained also contained, e.g. dietary advice, physical activity, education and self-monitoring of blood glucose [52]. This scoping review does not evaluate whether the effects of the interventions are consistent across different income levels or assess their economic and practical feasibility in resource-limited settings. However, it is important to notice that there is an inconsistency in current terminology for similar interventions, which may create confusion and misinterpretation among researchers, healthcare providers, and patients and complicate the comparison and synthesis of study results and meta-analyses. Further, reported outcomes are heterogeneous, which may not only reflect the complex association between GDM and various dimensions of health but also reflect that not all studies align their outcomes with the core outcome set (COS) for GDM [53]. Therefore, the scientific community should standardise the terminology used in GDM interventions, and future studies should, as a minimum, use the COS for GDM when developing future intervention studies.

Strengthens and limitations

This is the first comprehensive overview of GDM self-care interventions in LMIC in relation to the physical, mental, and social health dimensions in line with the WHO definition. Our review enhances understanding of the components of GDM self-care interventions and the types of outcomes interest. This insight may guide the planning of future research studies in LMICs to develop effective self-care interventions, and it shows a need for future studies to address mental and social health to a greater extent in future GDM self-care studies. There are a number of limitations of this scoping review, which should be highlighted. No meta-analysis was conducted, and we are therefore unable to assess the overall effect of different self-care interventions on physical, mental, and social health. Further, the quality of the included studies was not assessed; thus, we cannot rule out biases in the included studies.

Conclusions

This review shows that GDM self-care interventions conducted in LMICs are often complex and address various maternal and neonatal physical, mental, and social health outcomes. The content is heterogeneous and overlaps to a wide extent with non-pharmaceutical and lifestyle interventions, and we recommend that the scientific community use a standardised terminology and that future studies use the GDM COS when developing future intervention studies.

Data availability

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Abbreviations

GDM:

Gestational diabetes mellitus

c-section:

Caesarean section

T2D:

Type 2 diabetes

WHO:

World Health Organization

LMICs:

Low- and middle-income countries

PRISMA-SCR:

Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Extension for Scoping Review

QoL:

Quality of life

RCT:

Randomised controlled trial

PA:

Physical activities

SMBG:

Self-monitoring blood glucose

OGTT:

Oral glucose tolerance tests

BG:

Blood glucose

FBG:

Fasting blood glucose

1h-PBG:

1-h postprandial blood glucose

2h-PBG:

2-h postprandial blood glucose

HbA1c:

Glycated haemoglobin

SDS:

Self-Rating Anxiety Scale

PSS:

Perceived Stress Scale

SAS:

Self-Rating Depression Scale

COS:

Core Outcome Set

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Funding

This review was conducted as part of the research project “Living Together with Chronic Disease: Informal Support for Diabetes Management in Vietnam–Phase II: Gestational Diabetes in Vietnam (VALID II)”. The research project is funded by the Danish Ministry of Foreign Affairs, grant number “21-M03-KU”. The funder was not involved in the study and had no role in developing the study design, conduct, analysis, reporting, or decision to submit for publication.

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Authors and Affiliations

  1. Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam

    Ngoc-Anh Thi Dang, Hieu Minh Le, Ai Nguyen & Kien Dang Nguyen

  2. Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Per C. Glöde, Christina A. Vinter & Ditte S. Linde

  3. Department of Gynaecology & Obstetrics, Odense University Hospital, Odense, Denmark

    Christina A. Vinter & Ditte S. Linde

  4. Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Jannie Nielsen

  5. Department of Anthropology, University of Copenhagen, Copenhagen, Denmark

    Tine M. Gammeltoft

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Contributions

NATD participated in developing the search strategy, screening the articles, contributing to the analysis and interpretation of the data, and writing and revising the manuscript. HML participated in screening the articles and writing and revising the manuscript. AN participated in data extraction, manuscript writing, and revision. PCG participated in developing the search strategy, screening the articles, and extracting the data. CV participated in the study’s design, contributed to the data analysis, and substantively revised the study. KDN participated in data extraction and substantively revised the study. JN participated in data analysis, manuscript writing, and revision. TG participated in the study’s design, contributed to the data analysis, and substantively revised the study. DSL participated in the study’s design, developing the search strategy, screening the articles, contributing to the analysis and interpretation of the data, and writing the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Ngoc-Anh Thi Dang.

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Dang, NA.T., Le, H.M., Nguyen, A. et al. Self-care interventions among women with gestational diabetes mellitus in low and middle-income countries: a scoping review. Syst Rev 14, 50 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s13643-025-02790-7

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Systematic Reviews

ISSN: 2046-4053