Effectiveness of telemedicine for glucose control and pregnancy outcomes in gestational diabetes mellitus: systematic review and meta-analysis / 中华健康管理学杂志

ABSTRACT

Objective:This paper systematically reviews the application of telemedicine on glucose control and pregnancy outcome improvement among patients with GDM.Methods:We searched Cochrane Library databases, Scopus, Pubmed, Web of Science, CNKI, Wanfang Data database to collect English or Chinese randomized controlled trials (RCTs) related to the adoption of telemedicine interventions on glucose and clinical outcomes for GDM from January 2000 to June 2020. Literature screening, data extraction and evaluation of the risk of bias were done independently by two reviewers. RevMan 5.4 was conducted for meta-analysis.Results:16 RCTs were identified, with 1859 pregnancies. The meta-analysis found that telemedicine group had significantly reduced fasting blood glucose [MD=-0.41, 95% CI(-0.65, -0.17), P<0.001], 2-hour postprandial blood glucose (2hPBG) [MD=-1.08, 95% CI (-1.44, -0.73), P<0.001]、and HbA1c [MD=-0.73, 95% CI(-0.95, -0.50), P<0.001]. However there were no statistically significant differences in caesarean delivery rate [ OR=0.85,95% CI(0.55,1.31)], insulin adoption rate [ OR=0.94, 95% CI(0.46, 1.91)], macrosomia or large-for-age (LGA) rate [ OR=1.06, 95% CI (0.77, 1.46)], birth weight [MD=-14.10, 95% CI (-45.68, 73.87)], preelampsia or pregnancy-induced hypertension rate [ OR=1, 95% CI (0.51, 1.96)], neonatal hypoglycemia rate [ OR=0.81, 95% CI(0.42, 1.59)], or NICU admission rate [ OR=0.97, 95% CI (0.60, 1.57)] between telemedicine and traditional medicine model. Conclusion:Compared to traditional medicine model, telemedicine has its advantage in glucose control, but achieved similar ability in pregnancy outcome improvement.