Comparison 1. Telemedicine versus standard care for glucose monitoring.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Hypertensive disorders of pregnancy	4	275	Risk Ratio (M‐H, Fixed, 95% CI)	1.49 [0.69, 3.20]
1.1 Pre‐eclampsia, pregnancy‐induced hypertension	3	178	Risk Ratio (M‐H, Fixed, 95% CI)	1.29 [0.58, 2.89]
1.2 Pregnancy‐induced hypertension	1	97	Risk Ratio (M‐H, Fixed, 95% CI)	4.9 [0.24, 99.48]
2 Caesarean section	5	478	Risk Ratio (M‐H, Random, 95% CI)	1.05 [0.72, 1.53]
3 Perinatal mortality	2	131	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Large‐for‐gestational age	3	228	Risk Ratio (M‐H, Fixed, 95% CI)	1.41 [0.76, 2.64]
5 Death or serious morbidity composite	1	57	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.68, 1.66]
6 Operative vaginal birth (not a prespecified outcome)	1	47	Risk Ratio (M‐H, Fixed, 95% CI)	0.50 [0.11, 2.30]
7 Induction of labour	1	47	Risk Ratio (M‐H, Fixed, 95% CI)	1.06 [0.63, 1.77]
8 Placental abruption	2	154	Risk Ratio (M‐H, Fixed, 95% CI)	0.88 [0.12, 6.42]
9 Gestational weight gain (kg)	2	300	Mean Difference (IV, Fixed, 95% CI)	‐0.47 [‐1.50, 0.55]
10 Weight at 36 weeks (kg)	1	44	Mean Difference (IV, Fixed, 95% CI)	5.5 [‐5.69, 16.69]
11 Adherence to the intervention	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
11.1 Appointments attended (%)	1	47	Mean Difference (IV, Fixed, 95% CI)	5.20 [‐2.27, 12.67]
11.2 Average daily self‐monitoring of blood glucose frequency: meter memory	1	44	Mean Difference (IV, Fixed, 95% CI)	0.5 [‐0.42, 1.42]
11.3 Average daily self‐monitoring of blood glucose frequency: diary	1	45	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.66, 0.86]
11.4 Frequency of monitoring (number of data points)	1	57	Mean Difference (IV, Fixed, 95% CI)	21.10 [‐9.33, 51.53]
11.5 Frequency of monitoring (number of data sets)	1	74	Mean Difference (IV, Fixed, 95% CI)	1.20 [‐12.32, 14.72]
12 Sense of well‐being and quality of life: DES: Diabetes Empowerment Scale	1		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
12.1 Total	1	57	Mean Difference (IV, Fixed, 95% CI)	0.40 [0.14, 0.66]
12.2 Subscale 1: managing the psychosocial aspects of diabetes	1	57	Mean Difference (IV, Fixed, 95% CI)	0.5 [0.21, 0.79]
12.3 Subscale 2: assessing dissatisfaction and readiness to change	1	57	Mean Difference (IV, Fixed, 95% CI)	0.40 [0.14, 0.66]
12.4 Subscale 3: setting and achieving diabetes goals	1	57	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐0.04, 0.64]
13 Use of additional pharmacotherapy	5		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
13.1 Insulin	5	484	Risk Ratio (M‐H, Fixed, 95% CI)	1.52 [1.18, 1.96]
13.2 Oral agents	3	184	Risk Ratio (M‐H, Fixed, 95% CI)	0.85 [0.50, 1.42]
13.3 Insulin and oral agents	1	47	Risk Ratio (M‐H, Fixed, 95% CI)	1.24 [0.19, 8.06]
14 Maternal hypoglycaemia	1	203	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
15 Maternal hypoglycaemia: self‐monitored blood glucose episodes hypoglycaemic (< 3.9 mmol/L) (%)	1	44	Mean Difference (IV, Fixed, 95% CI)	‐0.10 [‐1.64, 1.44]
16 Glycaemic control: HbA1c (%)	3	357	Mean Difference (IV, Fixed, 95% CI)	‐0.15 [‐0.26, ‐0.04]
17 Glycaemic control: HbA1c < 5.8%	1	97	Risk Ratio (M‐H, Fixed, 95% CI)	1.0 [0.96, 1.04]
18 Glycaemic control: HbA1c at 36 weeks (mmol/mol)	1	30	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐2.03, 2.43]
19 Glycaemic control: self‐monitored blood glucose (mmol/L)	1	44	Mean Difference (IV, Fixed, 95% CI)	0.0 [‐0.30, 0.30]
20 Glycaemic control: fasting and 2‐hour post‐prandial blood glucose (mg/dL)	2		Mean Difference (IV, Random, 95% CI)	Subtotals only
20.1 Fasting blood glucose (mg/dL)	2	131	Mean Difference (IV, Random, 95% CI)	‐0.50 [‐5.38, 4.38]
20.2 2‐hour post‐prandial blood glucose (mg/dL)	2	131	Mean Difference (IV, Random, 95% CI)	‐0.21 [‐5.09, 4.67]
21 Stillbirth	3	178	Risk Ratio (M‐H, Fixed, 95% CI)	0.41 [0.02, 9.55]
22 Neonatal death	2	131	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
23 Gestational age at birth (weeks)	5	478	Mean Difference (IV, Fixed, 95% CI)	0.10 [‐0.18, 0.37]
24 Preterm birth < 37 weeks	4	275	Risk Ratio (M‐H, Fixed, 95% CI)	0.66 [0.31, 1.39]
25 Macrosomia	2	249	Risk Ratio (M‐H, Random, 95% CI)	1.43 [0.27, 7.52]
26 Small‐for‐gestational age	1	97	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
27 Birthweight (g)	5	477	Mean Difference (IV, Fixed, 95% CI)	63.13 [‐32.32, 158.59]
28 Head circumference (cm)	1	45	Mean Difference (IV, Fixed, 95% CI)	0.70 [0.02, 1.38]
29 Length (cm)	1	42	Mean Difference (IV, Fixed, 95% CI)	0.20 [‐1.34, 1.74]
30 Shoulder dystocia	2	142	Risk Ratio (M‐H, Fixed, 95% CI)	0.33 [0.01, 7.83]
31 Respiratory distress syndrome	3	176	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.26, 1.49]
32 Neonatal hypoglycaemia	3	198	Risk Ratio (M‐H, Fixed, 95% CI)	1.14 [0.48, 2.72]
33 Hyperbilirubinaemia or jaundice	3	176	Risk Ratio (M‐H, Fixed, 95% CI)	1.09 [0.59, 2.01]
34 Hypocalcaemia	1	97	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
35 Polycythaemia	1	97	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
36 Number of hospital or health professional visits: face‐to‐face visits	1	97	Mean Difference (IV, Fixed, 95% CI)	‐0.36 [‐0.92, 0.20]
37 Number of hospital or health professional visits: unscheduled face‐to‐face visits	1	97	Mean Difference (IV, Fixed, 95% CI)	‐0.62 [‐1.05, ‐0.19]
38 Neonatal intensive care unit admission	3	176	Risk Ratio (M‐H, Fixed, 95% CI)	1.05 [0.62, 1.79]
39 'Neonatal morbidity' (neonatal complications: e.g. hypoglycaemia, hyperbilirubinaemia, respiratory distress syndrome, shoulder dystocia, malformations) (not a prespecified outcome)	1	203	Risk Ratio (M‐H, Fixed, 95% CI)	1.52 [0.53, 4.38]
40 'Maternal morbidity' (maternal complications: gestational hypertension, pre‐eclampsia, eclampsia, hypoglycaemic episodes) (not a prespecified outcome)	1	203	Risk Ratio (M‐H, Fixed, 95% CI)	0.49 [0.13, 1.79]