Telemedicine care is an innovative healthcare delivery approach to help overcome difficulties with access to care. We sought to compare pregnancy outcomes with in-person and telemedicine Maternal-Fetal Medicine consultation in women with gestational diabetes mellitus (GDM).
This is a retrospective cohort study of 542 pregnant women with GDM who underwent Maternal-Fetal Medicine consultation between 2016 and 2017. GDM management included physician consultation, medical nutrition therapy counseling by a certified diabetes educator, and weekly glycemic surveillance for both telemedicine and in-person groups. We compared baseline maternal characteristics and pregnancy outcomes based on the type of care.
Telemedicine management was performed in 88 (16%) of women with GDM. Women undergoing telemedicine management were younger (29.6 vs 32.2, p<0.001), more likely to be obese (71.6 vs 55%, p=0.02), and to actively smoke (22.7 vs 11.1, p=0.01), but there were no differences in gestational age at GDM diagnosis (23.7 vs 25.1 weeks, p=0.06). Need for pharmacologic therapy was similar in both groups (53.4 vs. 54.8%, p=0.8). Also, mean fasting (100.5 vs 98.7 mg/dL, p=0.4) and postprandial (130.8 vs 129.9 mg/dL, p=0.7) glucose values were similar in women undergoing telemedicine and in-person consultation. Pregnancy outcomes did not differ by management type including preterm birth, hypertensive disorders of pregnancy and cesarean delivery. Neonatal outcomes were similar including NICU admission (17.1 vs. 25.2%, p=0.1) and composite neonatal morbidity (52.3 vs. 45.2%, p=0.2) in women with GDM undergoing telemedicine and in-person management.
We found no difference in pregnancy outcomes in women with GDM who underwent telemedicine or in-person management. Our findings suggest a potential role for telemedicine care in the management of women with GDM.
© 2018 Published by Elsevier Inc.