Remote patient monitoring for management of diabetes mellitus in pregnancy is associated with improved maternal and neonatal outcomes

Kantorowska, Agata; Cohen, Koral; Oberlander, Maxwell; Jaysing, Anna; Akerman, Meredith; Wise, Anne-Marie; Mann, Devin; Testa, Paul; Chavez, Martin; Vintzileos, Anthony M.; Heo, Hye

doi:10.1016/j.ajog.2023.02.015

Cited by 10 publications

(5 citation statements)

References 46 publications

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“…Mitanchez et al's study on the perinatal complications of infants born to GDM mothers showed that untreated moderate or severe GDM increased the risk of neonatal complications [29]. Kantorowska et al's retrospective cohort study of 176 mothers showed that improved remote patient monitoring of GDM mothers' blood glucose control could improve neonatal outcomes and reduce the incidence of neonatal sepsis [30]. A study that compared healthy pregnancies and well-controlled GDM in neonatal outcomes ( NICU admission rate) showed no differences [31].…”

Section: Discussionmentioning

confidence: 99%

Identification of risk factors and development nomogram for neonatal sepsis in Group B Streptococcus-colonized mothers: A retrospective study

Deng

Wang

et al. 2023

Preprint

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Background: Neonatal clinical sepsis is recognized as a significant health problem, This study sought to identify a predictive model of risk factors for clinical neonatal sepsis. Methods: A retrospective review about maternal-newborn dichotomy was conducted at our hospital from October 2018 to April 2023. The neonates were divided into cases and controls according to whether neonatal sepsis occurred . Multivariate logistic regression was used to determine risk factors and construct models. Results: 339 pairs of mothers and their newborns were included in the study and classified into cases (n=84, 24.78%) and controls(n=255, 75.22%) . Logistic regression analysis showed that maternal age ≥26 years (odds ratio [OR] =0.47, 95% confidence interval [CI] 0.23-0.96, p=0.038),umbilical cord winding([OR]=1.80,95%[CI]1.06-3.05,p=0.027), maternal gestational diabetes ([OR]=2.14, 95%[CI]1.09-4.20, p=0.027) and neonatal sex as female ([OR]=0.64,95%[CI]0.38-1.00,p=0.050), and forceps assisted delivery ([OR]=4.74, 95%[CI]1.23-18.19, p=0.023) were independent factors affecting neonatal clinical sepsis outcome. A main effects model incorporating the five significant factors was constructed to predict the occurrence of clinical sepsis in neonates with an AUC value of 0. 719 (95%CI：0653～0.786). Conclusions: A main effects model incorporating the five significant factors was constructed to help healthcare professionals make informed decisions and improve clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Identification of risk factors and development nomogram for neonatal sepsis in Group B Streptococcus-colonized mothers: A retrospective study

Deng

Wang

et al. 2023

Preprint

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“…The American Congress of Obstetricians and Gynecologists advocates for and supports remote patient monitoring in the clinical management of pregnancy-associated comorbid conditions such as diabetes and gestational diabetes, hypertension in pregnancy, and preeclampsia by tracking vital signs and optimizing patients’ health parameters while cutting down on the number of required specialist visits. 44 , 45 Also, teleconsultations via video conference or audio conference platforms can increase access to maternal-fetal medical care and other advanced obstetric care, which may ordinarily not be present in rural, isolated, or hard-to-reach areas. Medical collaborations between resident physicians and these specialists can expedite this process.…”

Section: Bridging Health Disparities: the Role Of Digital Healthmentioning

confidence: 99%

Digital health and health equity: How digital health can address healthcare disparities and improve access to quality care in Africa

Qoseem,

Okesanya,

Olaleke

et al. 2024

Health Promot Perspect

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The healthcare industry is constantly evolving to bridge the inequality gap and provide precision care to its diverse population. One of these approaches is the integration of digital health tools into healthcare delivery. Significant milestones such as reduced maternal mortality, rising and rapidly proliferating health tech start-ups, and the use of drones and smart devices for remote health service delivery, among others, have been reported. However, limited access to family planning, migration of health professionals, climate change, gender inequity, increased urbanization, and poor integration of private health firms into healthcare delivery rubrics continue to impair the attainment of universal health coverage and health equity. Health policy development for an integrated health system without stigma, addressing inequalities of all forms, should be implemented. Telehealth promotion, increased access to infrastructure, international collaborations, and investment in health interventions should be continuously advocated to upscale the current health landscape and achieve health equity.

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“… 54 In a retrospective cohort study, patients with diabetes mellitus in pregnancy who used remote glycemic monitoring were more likely to achieve glycemic control in the target range than those who used paper blood glucose logs (79% vs 52%; P <.0001) and were able to achieve the target range sooner. 59 For those with T2D in pregnancy, remote patient monitoring has demonstrated modest improvements in HbA1c levels. 54 , 60 , 61 …”

Section: Telehealthmentioning

confidence: 99%

“…A recent trial suggests that those who use remote glycemic monitoring have lower rates of preeclampsia than those who used manual glucose logs and their infants have lower rates of neonatal hypoglycemia in the first 24 hours of life (30% vs 52%; P <.0001). 59 With this technology being quickly incorporated into routine diabetes mellitus care, we are likely to see additional studies that examine the effect of telehealth on maternal and neonatal outcomes.…”

Section: Telehealthmentioning

confidence: 99%

The role of technology in the care of diabetes mellitus in pregnancy: an expert review

THAYER¹,

Lawlor²,

Williams³

2023

AJOG Global Reports

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Remote patient monitoring for management of diabetes mellitus in pregnancy is associated with improved maternal and neonatal outcomes

Cited by 10 publications

References 46 publications

Identification of risk factors and development nomogram for neonatal sepsis in Group B Streptococcus-colonized mothers: A retrospective study

Identification of risk factors and development nomogram for neonatal sepsis in Group B Streptococcus-colonized mothers: A retrospective study

Digital health and health equity: How digital health can address healthcare disparities and improve access to quality care in Africa

The role of technology in the care of diabetes mellitus in pregnancy: an expert review

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