A review of mHealth interventions for diabetes in pregnancy

Abstract

Gestational diabetes mellitus (GDM) has high morbidity and risk for mortality when mismanaged. This is particularly relevant in low- and middle-income countries (LMIC), where GDM related complications occur at a higher rate, with worse outcomes, due to a lack of healthcare resources. Mobile health (mHealth) presents an opportunity to improve the management of GDM in LMIC. We conducted a meta-analysis, which found that using mHealth as an intervention for GDM caused a statistically significant decrease of 0.38 mmol/L (95% CI -0.52 mmol/L to -0.23 mmol/L) in overall blood glucose levels during pregnancy compared to the control group. There was a significantly higher probability of vaginal deliveries in the intervention group than the control group (risk ratio (RR) = 1.18, 95% CI 1.03 to 1.36). It was less likely for new-borns from the intervention group to be diagnosed with hypoglycaemia than new-borns from the control group (RR = 0.67, 95% CI 0.48 to 0.93). This review found evidence for mHealth offering improvements in biological, maternal, perinatal, cognitive and economic outcomes by aiding in the management of GDM. This could be particularly important to LMIC where the lack of resources and high healthcare-related costs contribute to the mismanagement of GDM.