Table 1.
the impact of CGM on pregnancy outcomes and perinatal outcomes.
| Number | Country | Reference | Period | Size | Result | Recommendation | |||
|---|---|---|---|---|---|---|---|---|---|
| TID | T2D | GDM | Maternal | Offspring | |||||
| 1 | UK, Austria | 25 | 2018 | 24 | 11 | 39 | The blood glucose measured by CGM and SMBG are highly consistent, and CGM reduces the pain and burden of users. | – | CGM is safe and accurate to use by pregnant women with diabetes. |
| 2 | Australia | 32 | 2020 | – | – | 90 | CGM data revealed nocturnal hyperglycemia in patients who were not commenced on insulin, with 60% of subjects breaching glucose targets overnight for >10% time. SMBG is hard to get such results. | – | CGM can make a more comprehensive assessment of nocturnal hyperglycemia. |
| 3 | Australia | 35 | 2022 | – | – | 40 | CGM can evaluate the diurnal pattern of glucose metabolism and has the potential to identify false positive and false negative OGTT. | – | CGM was well accepted and could better demonstrate the blood glucose control of GDM patients. |
| 4 | Sweden | 45 | 2019 | 186 | – | – | – | High maternal average blood glucose level and low TIR during pregnancy were associated with increased risk of LGA in offspring and comprehensive adverse outcomes in newborns. | Despite the use of CGM throughout pregnancy, daily blood glucose control is not ideal, and the incidence of LGA is still high. |
| 5 | Denmark | 63 | 2021 | 20 | – | – | The TBR measured by is-CGM is higher than that measured by rt-CGM. | – | The type of CGM device may affect the judgment of nocturnal hypoglycemia and thus affect the adjustment of nocturnal insulin dose. |
| 6 | England | 52 | 2019 | 186 | – | – | – | Every 5% reduction in TIR and 5% increase in TAR in the second and third trimesters will increase the risk of older than gestational age infants, neonatal hypoglycemia and admission to the neonatal intensive care unit. | Pregnant women should monitor TIR through CGM and raise the TIR to>70% as early as possible during pregnancy. |
| 7 | Australia | 60 | 2007 | 8 | 10 | 37 | CGM can show undetected postprandial hyperglycemia and overnight hypoglycemia. | – | CGM is a practical clinical tool with good compliance and is helpful for clinical decision-making. |
| 8 | England | 62 | 2017 | 325 | – | – | Pregnant CGM users spent more time in target and less time hyperglycemic, less hypoglycemia episodes and less time spent hypoglycemic. | Lower incidence of large for gestational age, fewer neonatal intensive care admissions lasting more than 24h, fewer incidences of neonatal hypoglycemia, and 1-day shorter length of hospital stay. | CGM should be provided to all pregnant women with type 1 diabetes who use intensive insulin therapy. |
| 9 | Holland | 64 | 2018 | 109 | 82 | 109 | CGM can reduce the incidence of gestational hypertension and preeclampsia in patients with type 1 diabetes and improve the level of HbA1c. | the use of is-CGM did not reduce the risk of macrosomia | CGM provides detailed information concerning glycemic fluctuations but, as a treatment strategy, does not translate into improved pregnancy outcome. |
| 10 | Worldwide | 67 | 2022 | – | – | 482 | Women with GDM using CGM may achieve lower average blood glucose levels and lower maternal weight gain. | Compared with using SMBG, patients using CGM to monitor blood glucose birth infants with lower birth weight | CGM is good for both mother and infant. |
| 11 | England | 68 | 2021 | – | – | 100 | the average blood glucose was more stable and TIR was higher in the group using is-CGM. | – | CGM may help to improve and treat the glucose tolerance disorder during pregnancy |
| 12 | China | 69 | 2011-2012 | – | – | 340 | Subjects in the CGM group were at lower risk of preeclampsia and primary cesarean delivery | The mean infant birth weight of women in the CGM group was lower | The use of supplementary CGM combined with routine antenatal care can improve the glycemic control and pregnancy outcomes of patients with GDM |
| 13 | Spain | 74 | 2020 | – | – | 77 | Every 1% increase in TAR would increase the probability of requiring drug treatment by 24%. | TAR was related to the occurrence of macrosomia and large for gestational age infants. | Using CGM to monitor the blood glucose changes of GDM patients can identify those patients who need drug treatment as early as possible, and reduce the occurrence of adverse pregnancy outcomes |
| 14 | England | 76 | 2019 | – | – | 162 | Mothers who delivered LGA infants had significantly higher blood glucose at night. | – | Using CGM to monitor and control the nocturnal blood glucose may help reduce the incidence rate of LGA in GDM women. |
| 15 | England | 77 | 2008 | 46 | 25 | – | – | Women in the CGM group delivered significantly smaller babies than the SMBG group | CGM during pregnancy is associated with improved glycemic control in the third trimester, lower birth weight, and reduced risk of macrosomia. |