Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jun 4, 2026
Open Peer Review Period: Jun 5, 2026 - Jul 31, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The impact of telemedicine interventions on maternal and fetal outcomes in women with gestational diabetes: A systematic review and meta-analysis of randomized controlled trials
ABSTRACT
Background:
Gestational diabetes mellitus (GDM) has a growing global prevalence and brings multiple adverse short- and long-term hazards to mothers and fetuses. Conventional offline management is restricted by time and space limitations, accompanied by poor patient compliance and delayed individualized intervention. Telemedicine has gradually been applied to GDM management, yet existing relevant randomized controlled trial (RCT) conclusions remain inconsistent, lacking unified quantitative evidence.
Objective:
This meta-analysis systematically synthesizes available RCT evidence to quantitatively evaluate the comprehensive efficacy of telemedicine interventions on maternal glycemic metabolism, delivery modes and multiple neonatal adverse outcomes in women with gestational diabetes mellitus, so as to provide evidence-based references for optimizing clinical GDM management schemes.
Methods:
Relevant RCT literatures were comprehensively retrieved from PubMed, EMBASE, Cochrane Library, Web of Science and Scopus up to February 9, 2026. Strict inclusion and exclusion criteria based on PICOS framework were formulated. Two independent researchers completed literature screening, data extraction and Cochrane RoB 2 bias risk assessment, and meta-analysis was performed via STATA 18.0 software. Continuous outcomes were expressed as standardized mean difference (SMD), and dichotomous outcomes were summarized by odds ratio (OR) with 95%CI; fixed or random-effect models were selected according to heterogeneity (I²).
Results:
Altogether 17 eligible RCTs involving 2391 GDM pregnant women were included. Meta-analysis indicated telemedicine significantly reduced fasting blood glucose (SMD=-0.55, 95%CI:-0.94~-0.16) and 2-hour postprandial blood glucose (SMD=-0.62,95%CI:-1.20~-0.04), lowered the risks of emergency cesarean section (OR=0.65,95%CI:0.45~0.93), macrosomia (OR=0.49,95%CI:0.35~0.69), neonatal hypoglycemia (OR=0.60,95%CI:0.42~0.86) and neonatal respiratory distress (OR=0.61,95%CI:0.41~0.92). No statistically significant improvements were observed in overall cesarean delivery rate, gestational weight gain, preterm birth incidence and neonatal NICU admission rate.
Conclusions:
Telemedicine interventions effectively optimize glycemic control and decrease multiple adverse perinatal complications among GDM patients, serving as a valuable supplementary mode for routine prenatal care. Further large-sample, long-term follow-up RCTs are still required to verify its long-term maternal and infant clinical benefits. Clinical Trial: PROSPERO CRD420261403669; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251155941
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