A recent study published in the Journal of Telemedicine and Telecare found that telehealth can be safe and effective when it comes to managing high-risk pregnancies.
The meta-analysis, which examined 12 studies published in English and Turkish from 2016 through 2021, sought to examine how virtual care apps could affect maternal and neonatal health outcomes, as well as costs.
“It has actually been seen that due to the COVID-19 pandemic, the use of telehealth applications in the monitoring and care of high-risk pregnancies has increased substantially in antenatal health services,” wrote the researchers.
“It is for this reason that the need arose for a strong evidence-based examination of the effectiveness of telehealth, and this became the basis for the planning of the present study,” they said.
WHY IT MATTERS
According to the researchers, about 22% of pregnancies are considered high risk due to chronic health problems, infections, complications from previous pregnancies or other issues.
“The management of a high-risk pregnancy then may need an individualized and innovative approach,” they observed. “One of these innovative approaches is telehealth, which is being increasingly employed in recent years.”
The research team reviewed studies from around the world involving telehealth and high-risk pregnancies over the past five years. The interventions included smartphone apps, a web-based platform and telephone calls.
“We found that telehealth interventions had a positive impact on maternal/neonatal health, as well as on costs,” said the study. “Our results are important in that they indicate that modern technology can be used in the management of high-risk pregnancies.”
The telehealth intervention decreased the average number of face-to-face and ultrasound visits, but increased the number of nursing follow-ups by phone and the total number of nursing interventions. It did not have an effect on non-stress visits and receiving emergency obstetric care.
Researchers also found that fasting insulin, hemoglobin A1C levels before delivery and emergency cesarean-section rates were lower in the telehealth group, but the use of antenatal corticosteroids and hypoglycemic medication at delivery, compliance with actual blood glucose measurements, and induction intervention at delivery were higher.
Maternal mortality rates were also higher. However, as the study team noted, “Since this finding is based on the results of only one study in our review, it is clear that more research is necessary.” The same was true for neonatal mortality.
The groups were similar when it came to: the use of medical therapy, total gestational weight gain, health problems related to pregnancy, mode and complications of delivery, maternal intensive care unit admission, fetal-neonatal growth and development, neonatal health problems and mortality, follow-ups, and care costs.
“The results analyzed included various pregnancy risk groups, were collected from different telehealth applications, and were treated from a wide perspective that covered maternal, fetal and cost effects, all adding to the strengths of the study and reinforcing the outcomes,” wrote the researchers.
THE LARGER TREND
Researchers and innovators have turned to technology – such as remote patient monitoring and other telemedicine services – to try and address the maternal health and mortality crisis in the United States, which is particularly dire for Black women.
Other experts have also pointed to connectivity as playing a foundational role in addressing maternal care needs.
With more data about overlap between maternal outcomes and high-speed internet access, “we can better allocate our broadband resources in a way that most effectively benefits communities that need them, especially in the area of maternal health,” said Mayealie Adams, managing director of government and external affairs at Philips, in a December interview.
ON THE RECORD
“The results of this research and the recommendations of international health organizations show that health providers and administrators can use telehealth as a safe method in the monitoring and care of pregnant women at high risk, thus contributing to the improvement of antepartum care services,” wrote the study authors.
“At the same time, it might be suggested that randomized controlled studies are conducted on the effects of telehealth on different risk groups during pregnancy, which would lead to systematic reviews and meta-analyses that would provide stronger evidence,” they said.