Abstract
OBJECTIVE: To investigate the effects of digital health interventions (DHIs) for improving anthropometric and healthy behavior in women with polycystic ovarian syndrome (PCOS). METHODS: Five databases were searched from their inception to April 2025 with no date restrictions. Standardized mean differences (SMDs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using random-effects models. The certainty of the evidence was assessed using the GRADE approach. RESULTS: Ten trials with 930 participants were included. In short-term (≤3 months), DHIs yielded significant reductions in BMI (MD -1.19; -1.84 to -0.55; I²=0%), waist circumference (MD -2.14; -3.11 to -1.17; I²=0%) and large improvements in total HPLP-II score (SMD 1.61; 1.20 to 2.01; I²=0%), physical activity (SMD 1.43; 1.04 to 1.83; I²=0%), health responsibility (SMD 1.02; 0.64 to 1.39; I²=0%), interpersonal relationships (SMD 0.96; 0.59 to 1.33; I²=0%), spiritual growth (SMD 1.25; 0.87 to 1.64; I²=0%) and stress management (SMD 1.17; 0.79 to 1.55; I²=0%); there was no significant change in body weight (SMD -0.04; -0.23 to 0.15; I²=0%) or HPLP-II nutrition (SMD 0.83; -0.11 to 1.78; I²=84%). In medium-term (3-6 months), DHIs continued to reduce BMI (MD -2.46; -3.04 to -1.88; I²=22%) and waist circumference (MD -4.65; -6.70 to -2.60; I²=0%), and yielded significant improvements in depressive symptoms (SMD -0.85; -1.17 to -0.53; I²=17%) and anxiety (SMD -0.95; -1.33 to -0.56; I²=42%). CONCLUSION: Digital health interventions confer significant short- and medium-term improvements in anthropometric and healthy behavior measures among women with PCOS. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251030598.