TY - JOUR AU - Eberle, Claudia AU - Stichling, Stefanie PY - 2021 DA - 201/8/5 TI -在COVID-19期间管理妊娠糖尿病的远程医疗方法:系统评价JO - JMIR儿母SP - e28630 VL - 4 IS - 3kw -妊娠糖尿病KW -远程医疗KW -移动应用KW - COVID-19 KW -系统评价KW -数字健康KW -糖尿病AB -背景:2019年，中国出现了一种新型冠状病毒，由该病毒引起的疾病(COVID-19)迅速被列为大流行。患有妊娠期糖尿病(GDM)的孕妇被认为有患严重COVID-19的风险。在大流行的背景下，对于患有GDM的妇女对孕产妇和新生儿结局的不利影响存在严重关切。因此，GDM患者的有效治疗尤为重要。由于接触限制和感染风险，远程医疗等数字方法是合适的替代方案。目的:本系统综述旨在总结目前关于GDM和COVID-19孕妇孕产妇和后代结局的现有证据，并研究在COVID-19大流行期间改善孕产妇血糖控制的远程医疗干预措施。方法:通过检索Cochrane Library、MEDLINE via PubMed、Web of Science Core Collection、Embase和CINAHL数据库，系统地识别截至2021年3月发表的研究的出版物。我们根据结果对COVID-19研究进行了分类，并将远程医疗干预研究分为基于网络的组和基于应用程序的组。我们分析了病例报告(COVID-19)以及随机和非随机对照临床试验(远程医疗)。 To determine the change in glycated hemoglobin A1c (HbA1c), we pooled appropriate studies and calculated the differences in means, with 95% CIs, for the intervention and control groups at the end of the interventions. Results: Regarding COVID-19 studies, we identified 11 case reports, 3 letters, 1 case series, and 1 retrospective single-center study. In total, 41 patients with GDM and COVID-19 were analyzed. The maternal and neonatal outcomes were extremely heterogeneous. We identified adverse outcomes for mother and child through the interaction of GDM and COVID-19, such as cesarean deliveries and low Apgar scores. Furthermore, we selected 9 telemedicine-related articles: 6 were randomized controlled trials, 2 were clinical controlled trials, and 1 was a quasi-experimental design. In total, we analyzed 480 patients with GDM in the intervention groups and 494 in the control groups. Regarding the quality of the 9 telemedical studies, 4 were rated as strong, 4 as moderate, and 1 as weak. Telemedical interventions can contribute to favorable impacts on HbA1c and fasting blood glucose values in the context of the COVID-19 pandemic. Meta-analysis revealed a mean difference in HbA1c of –0.19% (95% CI 0.34% to 0.03%) for all telemedical interventions, –0.138% (95% CI –0.24% to –0.04%) for the web-based interventions, and –0.305% (96% CI –0.88% to 0.27%) for the app-based interventions. Conclusions: Telemedicine is an effective approach in the context of COVID-19 and GDM because it enables social distancing and represents optimal care of patients with GDM, especially with regard to glycemic control, which is very important in view of the identified adverse maternal and neonatal outcomes. Further research is needed. SN - 2561-6722 UR - https://pediatrics.www.mybigtv.com/2021/3/e28630 UR - https://doi.org/10.2196/28630 UR - http://www.ncbi.nlm.nih.gov/pubmed/34081604 DO - 10.2196/28630 ID - info:doi/10.2196/28630 ER -