The use of digital solutions for the reduction of maternal and perinatal mortality: A systematic review

Maternal and perinatal mortality are critical health and development indicators. Technological solutions, such as monitoring and telemedicine applications, have the potential to improve prenatal care and significantly reduce these risks by enhancing access to healthcare.

A systematic review of studies published between 2019 and 2026 was conducted. Searches were performed in Medline, Scopus, Web of Science, Scielo, and the Cochrane Central Register of Controlled Trials (CENTRAL). Observational and intervention studies evaluating digital solutions like teleconsultation, m-health, telecare, and mobile applications were considered.

Eight studies were included in the final review, encompassing a total population of 54,074 women. The primary digital solutions identified were teleconsultation (six studies), a mobile application (one study), and a telecare project (one study). The findings were mixed. A telecare system (WONDER project) in India was associated with a 50.1% reduction in maternal mortality. In Rwanda, the Safe Delivery Application was linked to a significant decrease in maternal deaths due to postpartum hemorrhage (from 3% to 0%, p=0.048) and the elimination of neonatal deaths post-resuscitation in the study group (from 7% to 0%, p<0.001). One study in Colombia found a statistically significant reduction in perinatal mortality with teleconsultation (OR= 0.22; 95% CI [0.07-0.71]; p= 0.022). However, other studies on teleconsultation did not find statistically significant differences in maternal or perinatal mortality rates.

Digital solutions integrated into clinical care, particularly telemonitoring systems and mobile applications, may reduce maternal and perinatal mortality in specific contexts. The evidence for teleconsultation as a standalone intervention remains inconclusive. Further high-quality research is needed to establish robust evidence for widespread implementation.