Perinatal Outcomes With Continuous Glucose Monitoring in Gestational Diabetes: A Systematic Review and Meta-Analysis

OBJECTIVES: To evaluate the effectiveness of continuous glucose monitoring (CGM) in women with gestational diabetes mellitus (GDM), with a focus on maternal and neonatal outcomes. METHODS: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were systematically searched up to March 2026 for randomized controlled trials. Pooled mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. RESULTS: Twelve studies involving 1639 women with GDM were included. The CGM use significantly improved time in range (MD = 2.52, 95% CI = 1.37 to 3.67) and was associated with a higher proportion of women requiring pharmacotherapy (RR = 1.15, 95% CI = 1.01 to 1.32). No significant differences were observed in maternal hemoglobin A1c (HbA1c) (MD = -0.11, 95% CI = -0.24 to 0.01), cesarean section (RR = 0.97, 95% CI = 0.85 to 1.10), large for gestational age (RR = 0.64, 95% CI = 0.40 to 1.02), macrosomia (RR = 1.13, 95% CI = 0.73 to 1.74), or neonatal hypoglycemia (RR = 0.86, 95% CI = 0.67 to 1.11). CONCLUSIONS: The CGM use in women with GDM significantly improves time in range and increases the use of pharmacotherapy, but it yields no significant differences in other maternal, neonatal, or glycemic outcomes.