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Type: Journal article
Title: The efficacy and effectiveness of continuous glucose monitoring during pregnancy: a systematic review
Author: Voormolen, D.
DeVries, J.
Evers, I.
Mol, B.
Franx, A.
Citation: Obstetrical and Gynecological Survey, 2013; 68(11):753-763
Publisher: Lippincott, Williams & Wilkins
Issue Date: 2013
ISSN: 0029-7828
Statement of
Daphne N. Voormolen, J. Hans DeVries, Inge M. Evers, Ben W. J. Mol, and Arie Franx
Abstract: Objective: Diabetic pregnancies carry a high risk for both mother and child, especially when glycemic control is poor. A novel technique that aims to improve glycemic control is the continuous glucose monitor (CGM). This tool is already in use to improve pregnancy outcome. This review presents the available evidence on the efficacy of CGM use in pregnancy and the effectiveness on pregnancy outcome. Methods: A systematic search was conducted using PubMed, EMBASE, and the Cochrane Libraries for articles on CGM in pregnancy. We evaluated the selected articles with particular attention for clinical and cost-effectiveness of CGM to improve pregnancy outcome. Results: We retrieved 5032 articles, 11 of which remained as relevant after selection according to predefined criteria. Most studies were limited to the evaluation of the role of CGM on clinical decision making. Only 2 studies were randomized controlled trials (RCTs) evaluating the effect on pregnancy outcome. One small RCT on retrospective CGM showed a significant reduction in third-trimester HbA1c and a significant reduction in neonatal macrosomia. A second RCT on real-time CGM did not show any effect on either glycemic control or on pregnancy outcome. Conclusions: Current evidence on the efficacy of CGM on improving glycemic control during pregnancy as well as on the effectiveness on pregnancy outcome is limited to 2 RCTs with contradicting results. Evidence on the cost-effectiveness is lacking. Further proper RCTs on the effectiveness and cost-effectiveness of CGM in pregnancy are required before wide implementation in practice.
Keywords: Humans
Pregnancy in Diabetics
Diabetes Mellitus, Type 1
Blood Glucose
Monitoring, Ambulatory
Pregnancy Outcome
Cost-Benefit Analysis
Rights: Copyright © 2013 by Lippincott Williams & Wilkins
DOI: 10.1097/OGX.0000000000000002
Appears in Collections:Aurora harvest 2
Paediatrics publications

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