Obstetrics & Gynecology · Endocrinology · 1 h ago
Remote monitoring for gestational diabetes reduced clinic visits, but safety non-inferiority was inconclusive
A pre-post study of 623 women with gestational diabetes at a Dutch teaching hospital compared usual care with a period when remote glucose monitoring was offered by default. Outpatient visits fell, but the study could not establish that remote monitoring was non-inferior for large-for-gestational-age births.
- Remote monitoring was used by 81% of the later-period group.
- LGA rates were 20.3% with monitoring and 17.8% with usual care.
- Non-inferiority for LGA was not established.
- Mean internal medicine visits fell from 2.8 to 1.6 per patient.
Researchers compared two groups of women with gestational diabetes at one Dutch teaching hospital: those treated with usual care from January 2020 to November 2022 and those treated from December 2022 to February 2025, when remote monitoring was the default alongside routine antenatal care. The pre-post study included 623 patients; 81% of the later-period group received remote monitoring. The primary outcome was large-for-gestational-age (LGA) newborns, with an 8-percentage-point non-inferiority margin. Caesarean sections, pregnancy-related complications and hospital service use were also assessed.
LGA occurred in 20.3% of newborns in the remote-monitoring group and 17.8% in the usual-care group. The estimated difference was 2.5 percentage points (95% CI, −3.9 to 9.0); because the upper confidence bound exceeded the prespecified margin, non-inferiority was not established. No significant differences in complication rates were reported. Mean internal medicine outpatient visits per patient were lower with remote monitoring (1.6 vs 2.8; p<0.001).
The findings suggest remote monitoring may reduce clinic visits, but do not establish comparable LGA outcomes. The single-hospital, retrospective pre-post design and insufficient sample size limit conclusions about clinical outcomes; the authors report no competing interests.
In practice
For women receiving gestational diabetes care in this single Dutch hospital, a remote-monitoring pathway was associated with fewer internal medicine outpatient visits, with no statistically significant differences reported in complications or caesarean sections. However, the study did not establish non-inferiority for large-for-gestational-age births: the confidence interval crossed the prespecified 8-percentage-point margin. Its retrospective pre-post design, single-centre setting and limited sample size mean the findings do not establish equivalent clinical outcomes or support a change in care pathways on their own.
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BMC Medicine: Remote monitoring for gestational diabetes: neonatal and maternal outcomes compared to usual care ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.