Effectiveness of Smartphone-Based Lifestyle Interventions on Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Hongjuan Wang; Yuanyuan Jiang; James Wiley; Lin Ge

doi:10.2147/PRBM.S389562

Effectiveness of Smartphone-Based Lifestyle Interventions on Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Psychol Res Behav Manag. 2022 Dec 5:15:3541-3559. doi: 10.2147/PRBM.S389562. eCollection 2022.

Authors

Hongjuan Wang¹, Yuanyuan Jiang¹, James Wiley², Lin Ge³

Affiliations

¹ Xiangya School of Nursing, Central South University, Changsha, People's Republic of China.
² Department of Family and Community Medicine and Institute for Health Policy, Research, University of California, San Francisco, CA, USA.
³ The Department of Alcohol Addiction and Internet Addiction, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, People's Republic of China.

Abstract

Background: Gestational diabetes mellitus (GDM) is a condition that causes poor glucose tolerance during pregnancy and usually resolves after birth. Having GDM impacts the mother and baby. Smartphone-based lifestyle interventions may offer innovative solutions.

Aim: To examine the effects of smartphone-based lifestyle interventions on compliance, Hemoglobin A1c (HbA1c), maternal outcomes, infant outcomes, psychological status, satisfaction, and cost effectiveness among women with GDM.

Methods: Randomized controlled trials (RCTs) of smartphone-based lifestyle interventions for women with GDM aged over 18 years were included. A systematic search of PubMed, Embase, Web of Science, CINAHL, and Cochrane Library for articles published from January 2007 to March 2022 and updated on 12 October 2022. Data were extracted independently by two researchers, and the risk of bias in individual trials was rated using the Cochrane risk-of-bias tool (RoB 2). Meta-analysis was conducted by using RevMan 5.3.

Results: Ten studies were included involving 1626 participants. The mean ages of the women were 32.42 ±4.68 years. Eight out of 10 studies were conducted in developed countries. Meta-analysis found that smartphone-based lifestyle interventions statistically improved compliance [SMD = 7.36, 95% CI = (4.05 to 10.68), P < 0.0001] and decreased the incidences of neonatal intensive care unit (NICU) admission [RR = 0.64, 95% CI = (0.47,0.86), P = 0.003], compared with controls. However, intervention effects on HbA1c, maternal outcomes, neonatal hypoglycemia, and infant birth weight were non significant. Moreover, the satisfaction of intervention is high in this review. Contrastingly, no significant effects were observed for psychological status and cost-effectiveness.

Conclusion: Smartphone-based lifestyle interventions may improve patient compliance and reduce NICU admissions. These findings may aid in developing future intervention strategies, help elucidate future research directions, and guide clinical practice for women with GDM. Future high-quality RCTs must be further studied at larger scales to examine smartphone-based lifestyle interventions' long-term effects and cost-effectiveness.

Keywords: gestational diabetes mellitus; lifestyle interventions; meta-analysis; smartphone; systematic review; women.

Publication types

Review