School of Nursing, Wuhan University, Wuhan, China.
Global Health of Project HOPE, Washington DC, USA.
Birth. 2024 Mar;51(1):13-27. doi: 10.1111/birt.12769. Epub 2023 Oct 3.
The current pandemic and future public health emergencies highlight the importance of evaluating a telehealth care model. Previous studies have reached mixed conclusions about the effectiveness of remote monitoring on glycemic control and maternal and infant outcomes in women with gestational diabetes mellitus (GDM).
This meta-analysis aimed to evaluate the effectiveness of remote blood glucose monitoring for women with gestational diabetes mellitus and to provide evidence-based guidance on the management of women with gestational diabetes mellitus for policymakers and healthcare providers during situations such as pandemics or natural disasters.
The Cochrane Library, PubMed, Web of Science, EBSCO, Embase, Medline, CINAHL databases, and ClinicalTrials.gov were systematically searched from their inception to July 10, 2021. Randomized controlled trials (RCTs) published in English with respect to remote blood glucose monitoring in women with GDM were included in the meta-analysis. Two independent reviewers performed data extraction and assessed the quality of the studies. Risk ratios, mean differences, 95% confidence intervals, and heterogeneity were calculated.
A total of 1265 participants were included in the 11 RCTs. There were no significant differences in glycemic control and maternal-fetal outcomes between the remote monitoring group and a standard care group, which included glycosylated hemoglobin (HbA1c), fasting blood glucose, mean 2-h postprandial blood glucose, caesarean birth, gestational weight gain, shoulder dystocia, neonatal hypoglycemia, and other outcomes.
This meta-analysis reveals that it is unclear if remote glucose monitoring is preferable to standard of care glucose monitoring. To improve glycemic control and maternal-fetal outcomes during the current epidemic or other natural disasters, the implementation of double-blind RCTs in the context of simulating similar disasters remains to be studied in the future.
当前的大流行和未来的公共卫生紧急情况凸显了评估远程医疗模式的重要性。先前的研究对于远程监测对妊娠糖尿病（GDM）妇女的血糖控制和母婴结局的有效性得出了混合结论。
本荟萃分析旨在评估远程血糖监测对妊娠糖尿病妇女的有效性，并为决策者和医疗保健提供者在大流行或自然灾害等情况下管理妊娠糖尿病妇女提供循证指导。
系统检索了 Cochrane 图书馆、PubMed、Web of Science、EBSCO、Embase、Medline、CINAHL 数据库和 ClinicalTrials.gov，检索时间从建库到 2021 年 7 月 10 日。纳入了关于 GDM 妇女远程血糖监测的发表在英文期刊上的随机对照试验（RCT）。两名独立的综述作者进行了数据提取并评估了研究质量。计算了风险比、均数差、95%置信区间和异质性。
共有 11 项 RCT 纳入了 1265 名参与者。远程监测组与标准护理组在血糖控制和母婴结局方面没有显著差异，包括糖化血红蛋白（HbA1c）、空腹血糖、餐后 2 小时平均血糖、剖宫产分娩、孕期体重增加、肩难产、新生儿低血糖和其他结局。
本荟萃分析表明，远程血糖监测是否优于标准护理血糖监测尚不清楚。为了在当前疫情或其他自然灾害期间改善血糖控制和母婴结局，未来仍需要在模拟类似灾害的背景下开展双盲 RCT 研究。
