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

OBJECTIVE: This review aimed to evaluate the effectiveness of digital health interventions (DHIs) for gestational diabetes mellitus (GDM) 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 (SMD = -0.67, 95% CI: -1.25 to -0.08) and improved both off-target fasting glucose (MD = -3.70, 95% CI: -3.83 to -3.57) and off-target postprandial glucose (MD = -4.56, 95% CI: -6.64 to -2.48) levels. 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 HDL cholesterol levels (SMD = 0.28, 95% CI: 0.05 to 0.52). Further, DHIs enhanced compliance with blood glucose monitoring (MD = 15.86, 95% CI: 10.92 to 20.79). However, no significant effects were observed on fasting glucose and HbA1c levels and delivery and postnatal outcomes. CONCLUSION: DHIs offer a promising solution for managing GDM, particularly through postprandial glucose control, lipid regulation, and self-monitoring adherence. Their limited impact on fasting glucose and 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.