Artificial Intelligence in Gestational Diabetes Care: A Systematic Review.

BACKGROUND

Artificial intelligence (AI) has emerged as a transformative tool for advancing gestational diabetes mellitus (GDM) care, offering dynamic, data-driven methods for early detection, management, and personalized intervention.

OBJECTIVE

This systematic review aims to comprehensively explore and synthesize the use of AI models in GDM care, including screening, diagnosis, management, and prediction of maternal and neonatal outcomes. Specifically, we examine (1) study designs and population characteristics; (2) the use of AI across different aspects of GDM care; (3) types of input data used for AI modeling; and (4) AI model types, validation strategies, and performance metrics.

METHODS

A systematic search was conducted across six electronic databases, identifying 126 eligible studies published up to February 2025. Data extraction and quality appraisal were independently conducted by six reviewers, using a modified version of the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool for risk of bias assessment.

RESULTS

Among 126 studies, 75% employed retrospective designs, with sample sizes ranging from 17 to over 100 000 participants. Most AI applications (85%) focused on early GDM prediction, while fewer addressed management, outcomes, or monitoring. Classical machine learning dominated (84%), with logistic regression and random forest frequently used. Internal validation was common (68%), but external validation was rare (6%). Our risk of bias appraisal indicated an overall moderate-to-good methodological quality, with notable deficiencies in analysis reporting.

CONCLUSIONS

AI demonstrates strong potential to improve GDM prediction, screening, and management. Nonetheless, broader validation, enhanced model interpretability, and prospective studies in diverse populations are needed to translate these technologies into clinical practice.