Continuous glucose monitoring as a method for predicting obstetric and perinatal complications in pregnant women with pregestational diabetes mellitus: a systematic review

Recent research has demonstrated the effectiveness of continuous glucose monitoring systems in improving obstetric and perinatal outcomes in women with diabetes mellitus. Furthermore, these systems have opened up opportunities for stratifying patients based on their glycemic profiles, known as glucotypes, which, in turn, enables a more personalized approach to predicting complications and choosing treatment strategies.

This article was aimed to analyze glycemic profile data obtained, using continuous glucose monitoring systems in pregnant women with pregestational diabetes mellitus, in order to study predictors of obstetric and perinatal complications, according to the available literature.

We conducted a systematic review of publications from MEDLINE, PubMed, EMBASE and CSCD databases from 2005 to 2024. Fourteen studies that met the inclusion criteria were included in the analysis. The primary endpoints were continuous glucose monitoring data, glycated hemoglobin levels, and the incidence of preeclampsia, preterm birth, macrosomia, and neonatal hypoglycemia.

Continuous glucose monitoring has been shown to be associated with lower glycated hemoglobin levels, increased time spent in the target glucose range, and decreased incidence of macrosomia, neonatal hypoglycemia, and neonatal intensive care unit admissions. The use of new methods of glycemic profile assessment such as glucotype allocation based on continuous glucose monitoring data opens up new opportunities for personalized pregnancy management.

Continuous glucose monitoring can significantly improve glycemic control in pregnant women with pregestational types of diabetes mellitus and optimize insulin therapy, while helping to reduce the incidence of adverse obstetric and perinatal outcomes. Stratification by glucotype may be a promising avenue for personalization of therapy.