AUTHOR=Shao Yu , Meng Chao , Liang Ying-Zhi 

TITLE=Digital versus non-digital health interventions to improve iron supplementation in pregnant women: a systematic review and meta-analysis

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1375622

DOI=10.3389/fmed.2024.1375622

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Objective</title><p>To investigate the effects of digital health interventions for improving adherence to oral iron supplementation in pregnant women.</p></sec><sec id="sec2"><title>Literature search</title><p>Five databases were searched from their inception to October 2023 with no date restrictions.</p></sec><sec id="sec3"><title>Study selection</title><p>Randomized controlled trials (RCTs) that assessed the effects of digital health interventions on adherence to oral iron supplementation (e.g., tablets and capsules) compared to non-digital health interventions for pregnant women were eligible.</p></sec><sec id="sec4"><title>Data synthesis</title><p>We calculated standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs) for continuous variables using the inverse variance method. We calculated odds ratios (OR) with 95%CI for categorical variables using the Mantel–Haenszel model. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The risk of bias of the included RCTs was assessed using the Cochrane risk of bias tool 2.0.</p></sec><sec id="sec5"><title>Results</title><p>Ten trials with 1,633 participants were included. Based on 7 trials, digital health interventions can improve objective adherence rate comparing with non-digital health interventions (1,289 participants, OR = 4.07 [2.19, 7.57], <italic>p</italic> &lt; 0.001, I<sup>2</sup> = 69%) in pregnant women. Digital health interventions can improve subjective adherence behavior comparing with non-digital health interventions (3 trials, 434 participants, SMD = 0.82 [0.62, 1.01], <italic>p</italic> &lt; 0.001, I<sup>2</sup> = 0%) in pregnant women. Based on 3 trials, digital health interventions can improve tablets consumption comparing with non-digital health interventions (333 participants, SMD = 1.00 [0.57, 1.42], <italic>p</italic> &lt; 0.001, I<sup>2</sup> = 66%) in pregnant women. Digital health interventions can improve hemoglobin level comparing with non-digital health interventions (7 trials, 1,216 participants, MD = 0.59 [0.31, 0.88], <italic>p</italic> &lt; 0.001, I<sup>2</sup> = 93%) in pregnant women.</p></sec><sec id="sec6"><title>Conclusion</title><p>Digital health interventions were effective at improving adherence to oral iron supplementation and hemoglobin levels in pregnant women.</p></sec>