数字健康干预措施与孕产妇和新生儿结局的关联：系统评价与荟萃分析

Association of Digital Health Interventions With Maternal and Neonatal Outcomes: Systematic Review and Meta-Analysis.

作者信息

Wang Jianing, Tang Nu, Jin Congcong, Yang Jianxue, Zheng Xiangpeng, Jiang Qiujing, Li Shengping, Xiao Nian, Zhou Xiaojun

机构信息

Department of Maternal and Child Information Management, Women and Children's Hospital of Chongqing Medical University, Chonqing, China.

Community Health Care Office, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

J Med Internet Res. 2025 Mar 14;27:e66580. doi: 10.2196/66580.

DOI:10.2196/66580

PMID:40085842

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11953608/

Abstract

BACKGROUND

Gestational weight gain (GWG) is crucial to maternal and neonatal health, yet many women fail to meet recommended guidelines, increasing the risk of complications. Digital health interventions offer promising solutions, but their effectiveness remains uncertain. This study evaluates the impact of such interventions on GWG and other maternal and neonatal outcomes.

OBJECTIVE

This study aimed to investigate the effect of digital health interventions among pregnant women and newborns.

METHODS

A total of 2 independent researchers performed electronic literature searches in the PubMed, Embase, Web of Science, and Cochrane Library databases to identify eligible studies published from their inception until February 2024; an updated search was conducted in August 2024. The studies included randomized controlled trials (RCTs) related to maternal and neonatal clinical outcomes. The Revised Cochrane risk-of-bias tool for randomized trials was used to examine the risk of publication bias. Stata (version 15.1; StataCorp) was used to analyze the data.

RESULTS

We incorporated 42 pertinent RCTs involving 148,866 participants. In comparison to the routine care group, GWG was markedly reduced in the intervention group (standardized mean difference-0.19, 95% CI -0.25 to -0.13; P<.001). A significant reduction was observed in the proportion of women with excessive weight gain (odds ratio [OR] 0.79, 95% CI 0.69-0.91; P=.001), along with an increase in the proportion of women with adequate weight gain (OR 1.33, 95% CI 1.10-1.64; P=.003). Although no significant difference was reported for the proportion of individuals below standardized weight gain, there is a significant reduction in the risk of miscarriage (OR 0.66, 95% CI 0.46-0.95; P=.03), preterm birth (OR 0.8, 95% CI 0.75-0.86; P<.001), as well as complex neonatal outcomes (OR 0.93, 95% CI 0.87-0.99; P=.02). Other maternal and fetal outcomes were not significantly different between the 2 groups (all P>.05).

CONCLUSIONS

The findings corroborate our hypothesis that digitally facilitated health care can enhance certain facets of maternal and neonatal outcomes, particularly by mitigating excessive weight and maintaining individuals within a reasonable weight gain range. Therefore, encouraging women to join the digital health team sounds feasible and helpful.

TRIAL REGISTRATION

PROSPERO CRD42024564331; https://tinyurl.com/5n6bshjt.

摘要

背景

孕期体重增加对母婴健康至关重要，但许多女性未达到推荐指南，增加了并发症风险。数字健康干预提供了有前景的解决方案，但其有效性仍不确定。本研究评估此类干预对孕期体重增加及其他母婴结局的影响。

目的

本研究旨在调查数字健康干预对孕妇和新生儿的影响。

方法

共有2名独立研究人员在PubMed、Embase、Web of Science和Cochrane图书馆数据库中进行电子文献检索，以识别从数据库建立至2024年2月发表的符合条件的研究；2024年8月进行了更新检索。纳入的研究包括与母婴临床结局相关的随机对照试验（RCT）。使用修订的Cochrane随机试验偏倚风险工具检查发表偏倚风险。采用Stata（版本15.1；StataCorp）进行数据分析。

结果

我们纳入了42项相关RCT，涉及148,866名参与者。与常规护理组相比，干预组的孕期体重增加显著减少（标准化均值差-0.19，95%CI -0.25至-0.13；P<.001）。体重增加过多的女性比例显著降低（比值比[OR]0.79，95%CI 0.69 - 0.91；P=.001），体重增加适当的女性比例增加（OR 1.33，95%CI 1.10 - 1.64；P=.003）。虽然标准化体重增加以下个体的比例未报告显著差异，但流产风险（OR 0.66，95%CI 0.46 - 0.95；P=.03）、早产风险（OR 0.8，95%CI 0.75 - 0.86；P<.001）以及复杂新生儿结局风险（OR 0.93，95%CI 0.87 - 0.99；P=.02）均显著降低。两组间其他母婴结局无显著差异（所有P>.05）。