Effectiveness of continuous glucose monitoring on maternal and neonatal outcomes in diabetic perinatal women: A systematic review and meta-analysis

Abstract

Background: Diabetes during pregnancy may result in complications in women and their developing babies. Poor glycaemic control is associated with higher risks of birth defects and pregnancy problems. The continuous glucose monitoring (CGM) system aims to improve pregnancy outcomes by providing a comprehensive glucose trend. Aims: The aim of this systematic review is to assess the effectiveness of continuous glucose monitoring system on maternal and neonatal outcomes in diabetic perinatal women. Methods: A comprehensive search was conducted within six databases: PubMed, EMBASE, CINHAHL, PsycINFO, Cochrane Library and Scopus. Studies' quality was appraised using the risk of bias tool and GRADE. A standardised extraction form was used for data extraction. Searching, quality appraisal and extraction of data were done independently by two authors. The RevMan software was used to conduct meta-analysis. Heterogeneity was assessed using X2 and I2. Overall effect was determined by effect size and Z-statistics. Eligibility criteria: Studies involving diabetic perinatal women allocated to either CGM or standard care measuring glycated haemoglobin A1c (HbA1c) level and neonatal birthweight were included. Results: Among the 1215 records identified, 10 andomised controlled trials were selected, involving a total of 1,358 perinatal women. Meta-analysis revealed that the use of CGM significantly improved HbA1c levels (d=0.43) and has a positive impact on neonatal birthweight (d=0.17), when compared to the standard care group.Conclusion: CGM is beneficial in reduction of HbA1c levels and improving neonatal birthweight in diabetic perinatal women. Implication: Findings are essential to professionals intending to reduce adverse pregnancy outcomes by maintaining HbA1c levels within the acceptable range in diabetic perinatal women. Larger trials are also necessary Future studies should involve larger trials and sample size with clear reporting of studies based on the CONSORT and Template for Intervention Description and Replication.