摘要目的:系统评价远程医疗对妊娠期糖尿病孕妇血糖控制和妊娠结局的作用。方法:在Cochrane Library databases，Scopus，Pubmed，Web of Science，中国知网和万方数据库中检索中英文随机对照研究（RCT），检索时限为2000年1月至2020年6月。由2名研究者独立筛选研究、提取数据资料并进行评价，采用RevMan 5.4软件进行荟萃分析。结果:共纳入16个RCT，包括1 859名孕妇。荟萃结果发现，远程医疗降低空腹血糖［MD=-0.41，95% CI（-0.65，-0.17）， P<0.001］、餐后2h血糖［MD=-1.08（95% CI（-1.44，-0.73）， P<0.001］、HbA1c［MD=-0.73，95% CI（-0.95，-0.50）， P<0.001］比传统诊疗模式更显著；但在剖宫产率［ OR=0.85，95% CI（0.55，1.31）］、胰岛素使用率［ OR=0.94，95% CI（0.46，1.91）］、巨大儿和LGA发生率［ OR=1.06，95% CI（0.77，1.46）］、新生儿出生体重［MD=-14.10，95% CI（-45.68，73.87）］、妊娠期高血压和先兆子痫的发生率［ OR=1，95% CI（0.51，1.96）］、新生儿低血糖发生率［ OR=0.81，95% CI（0.42，1.59）］，和新生儿重症监护病房入院率发生率［ OR=0.97，95% CI（0.60，1.57）］的差异无统计学意义。 结论:远程医疗与传统医疗相比，其在血糖控制方面更有优势，但在妊娠结局方面则没有显著的改善作用。

abstractsObjective:This paper systematically reviews the application of telemedicine on glucose control and pregnancy outcome improvement among patients with GDM.Methods:We searched Cochrane Library databases, Scopus, Pubmed, Web of Science, CNKI, Wanfang Data database to collect English or Chinese randomized controlled trials (RCTs) related to the adoption of telemedicine interventions on glucose and clinical outcomes for GDM from January 2000 to June 2020. Literature screening, data extraction and evaluation of the risk of bias were done independently by two reviewers. RevMan 5.4 was conducted for meta-analysis.Results:16 RCTs were identified, with 1859 pregnancies. The meta-analysis found that telemedicine group had significantly reduced fasting blood glucose [MD=-0.41, 95% CI(-0.65, -0.17), P<0.001], 2-hour postprandial blood glucose (2hPBG) [MD=-1.08, 95% CI (-1.44, -0.73), P<0.001]、and HbA1c [MD=-0.73, 95% CI(-0.95, -0.50), P<0.001]. However there were no statistically significant differences in caesarean delivery rate [ OR=0.85,95% CI(0.55,1.31)], insulin adoption rate [ OR=0.94, 95% CI(0.46, 1.91)], macrosomia or large-for-age (LGA) rate [ OR=1.06, 95% CI (0.77, 1.46)], birth weight [MD=-14.10, 95% CI (-45.68, 73.87)], preelampsia or pregnancy-induced hypertension rate [ OR=1, 95% CI (0.51, 1.96)], neonatal hypoglycemia rate [ OR=0.81, 95% CI(0.42, 1.59)], or NICU admission rate [ OR=0.97, 95% CI (0.60, 1.57)] between telemedicine and traditional medicine model. Conclusion:Compared to traditional medicine model, telemedicine has its advantage in glucose control, but achieved similar ability in pregnancy outcome improvement.