The Impact of Mobile Health (mHealth) Apps on Gestational Diabetes: A Systematic Review

Abstract

Gestational diabetes mellitus (GDM) poses a significant health risk for pregnant women, as it is associated with an increased likelihood of developing type II diabetes and cardiovascular complications. In addition, there is a high risk for pregnancy-related complications, emphasizing the need for effective management of GDM. This study aimed to investigate the potential impact of mHealth applications on gestational diabetes-related outcomes. A systematic review was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted in Pubmed, Scopus, and Web of Science, using the following search terms: (smartphone* OR mobile OR mHealth OR "mobile health") AND ("gestational diabetes" OR "maternal diabetes" OR "pregnancy diabetes" OR "pregnancy-induced diabetes" OR "perinatal diabetes"). In order to be included in the systematic review, the studies had to be papers published in peer-reviewed journals, published from February 2, 2020 to February 2, 2025, in the English language, being randomized trials, evaluating the impact of mHealth apps on women with GDM, excluding studies that incorporated additional technological interventions (e.g., WeChat supportive groups). The extracted data were the following: authors, country, total and per group number of participants, participants' characteristics, interventional content, assessments, time of the assessments, results, and potential information about participant adherence. The Jadad Scale was used for quality evaluation. Six studies met the predefined criteria and were included in the systematic review. Three studies found no or minimal benefits from the use of such applications. One study demonstrated highly significant benefits, not only in the management of GDM but also in reducing pregnancy-related complications. Another study indicated greater adherence to treatment and fewer admissions to neonatal intensive care units, while a third study reported a shift toward better postpartum health behaviors, which was closely associated with the use of mHealth applications, suggesting that those apps could support women in adopting healthier habits after childbirth. All studies reporting positive outcomes were carried out in Eastern Asian Countries (Singapore and China), whereas studies conducted in Europe found minimal or no benefits. The score on the Jadad Scale ranged from 2 to 3, indicating moderate to low quality. Οverall, while some promising findings were observed, further research is essential to evaluate these apps more thoroughly and enhance their effectiveness. Greater culturally influenced adherence to healthcare instructions leads to more significant benefits for Asian women with GDM. Cultural factors should be carefully considered when designing and implementing mHealth applications for women with GDM.

Keywords: diabetes gestational; intelligent systems; mobile apps (mhealth); pregnancy; women.

Figure 1. Selection process for the included studies