The impact of remote care on the quality of care of pregnant women with diabetes: a systematic review protocol

Abstract Background Diabetes during pregnancy, whether gestational diabetes mellitus (GDM) or pre-existing diabetes mellitus (DM), is associated with increased maternal and neonatal risks. Remote care has shown promise in managing diabetes in the general population, however, its impact on the quality of antenatal care for pregnant women with diabetes remains unclear. Considering the growing adoption of remote care globally, it is vital to understand its impact on the quality of care. This review aims to evaluate the impact of remote care on the quality of care for pregnant women with diabetes. This manuscript describes the protocol for the review. Methods MEDLINE, EMBASE, CINAHL, MIDIRS, Scopus, Cochrane, and Global Health databases will be searched to identify studies published from 2005 to 2025. Eligible studies will include original empirical research, encompassing both interventional (e.g. randomised controlled trials) and observational designs (e.g. cohort and cross-sectional studies), assessing remote care, including both virtual consultations and remote monitoring, for pregnant women with GDM, Type 1 or 2 DM. Quality of care will be assessed using the Institute of Medicine healthcare quality framework: patient-centredness, effectiveness, safety, efficiency, timeliness, and equity. Screening and data extraction will be conducted by two independent reviewers. The quality of the studies will be assessed using the Cochrane Risk of Bias tools. Subgroup analyses will be undertaken to explore variation by diabetes and intervention type. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) guideline. Discussion The findings of this review will provide evidence on the impact of remote care on the quality of care for pregnant women with pre-existing DM and GDM. Strengthening the evidence will support the development of evidence-based implementation strategies and inform policy decisions to ensure safe, effective, and patient-centred use of remote care interventions. Systematic review registration PROSPERO CRD420251024685.