Effects of Digital Health Interventions in Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-analysis.

PURPOSE: This review aimed to evaluate the effectiveness of digital health interventions (DHIs) for gestational diabetes mellitus management, focusing on the improvement of blood glucose and lipid levels, as well as maternal and neonatal outcomes.

METHODS

The PubMed, Embase, Cochrane Library, and CINAHL databases were searched for studies published up to September 30, 2024. Randomized controlled trials evaluating the effects of DHIs for gestational diabetes were included. The search terms included concepts related to gestational diabetes, digital health, and randomized trials. The quality of the included studies was assessed using the Cochrane Risk of Bias 2.0 tool. Meta-analyses were performed using the Review Manager software (RevMan version 5.4).

RESULTS

A total of 26 studies were included. DHIs significantly reduced postprandial glucose levels (standardized mean difference [SMD] = -0.67, 95% confidence interval [CI]: -1.25 to -0.08) and improved off-target fasting glucose (MD = -3.70, 95% CI: -3.83 to -3.57). DHIs also improved lipid profiles, resulting in a reduction in total cholesterol (SMD = -0.25, 95% CI: -0.49 to -0.01) and triglyceride levels (SMD = -0.28, 95 % CI: -0.51 to -0.04), and an increase in high-density lipoprotein cholesterol levels (SMD = 0.28, 95% CI: 0.05-0.52). However, given the very high heterogeneity (I2 = 99%) and the small number of studies (k = 3), this pooled estimate should be interpreted with caution. Furthermore, DHIs enhanced compliance with blood glucose monitoring (MD = 15.86, 95% CI: 10.92-20.79). However, no significant effects were observed on fasting glucose, HbA1c levels, delivery, and postnatal outcomes.

CONCLUSION

DHIs offer a promising solution for managing gestational diabetes mellitus, particularly through postprandial glucose control, lipid regulation, and self-monitoring adherence. Their limited impact on fasting glucose, HbA1c levels, and perinatal outcomes suggests that enhanced personalization, professional integration, and long-term monitoring are essential to maximize their effectiveness. Digital health strategies should evolve into comprehensive care models that support maternal and neonatal health, particularly in high-risk situations.