Effectiveness of continuous glucose monitoring on maternal and neonatal outcomes in gestational diabetes mellitus: a systematic review and meta-analysis

Background: Continuous Glucose Monitoring (CGM) by providing real-time glucose data and glucose trends is a useful tool in the management of gestational diabetes mellitus (GDM). This systematic review and meta-analysis of Randomized Clinical Trials (RCTs) evaluated the impact of CGM on maternal and neonatal outcomes in women with GDM. Methods: A comprehensive search of PubMed, Cochrane Library, EMBASE, and Scopus identified RCTs comparing CGM with SMBG in women with GDM. Outcomes were analyzed using mean differences and odds ratios, with meta-analysis performed in RevMan 5.4. Results: Five studies were included in this review. Maternal outcomes showed a significant reduction in HbA1c [MD: -0.21% (-0.39, -0.03) p = 0.02] with CGM compared to Self-Monitoring of Blood Glucose (SMBG). Neonatal outcomes indicated a lower rate of macrosomia [OR: 0.50 (0.40, 0.61) p < 0.00001] and reduced birth weight [MD: -151.68 gm (-237.21, -66.14) p = 0.0005] in the CGM group. However, no significant differences were observed in other secondary outcomes. Conclusion: The study demonstrated that the CGM group had a significantly lower HbA1c, with lower rates of macrosomia and reduced birth weights compared to SMBG. While CGM is effective for improving outcomes in GDM, further research is needed to establish pregnancy-specific glucose targets and address cost and accessibility challenges.