Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 15, 2021
Open Peer Review Period: Apr 15, 2021 - Jun 10, 2021
Date Accepted: Nov 15, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mobile phone application use in pregnant women: does it make a difference? Usage and perinatal outcomes in China
ABSTRACT
Background:
Maternal and child health (MCH) related mobile applications (apps) are becoming increasingly popular amongst pregnant women, however, few have demonstrated they lead to improvements in pregnancy outcomes.
Objective:
This study aimed to investigate the use of MCH apps amongst pregnant women and explore associations with pregnancy outcomes in China.
Methods:
A retrospective study was conducted in six maternal and child health hospitals in Northern China. Women who delivered a singleton baby greater than 28 weeks gestation in the study hospitals were sequentially recruited from postnatal wards during October 2017 to January 2018. Information was collected on self-reported MCH app use during their pregnancy, with clinical outcomes. Women were categorized as non-users of MCH apps, and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight <2500 grams, birth defects, stillbirth and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis.
Results:
The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 457 (24.7%); intermittent 876 (47.4%); and continuous 517 (27.9%). Amongst app users, the most common reasons for app use were for health education (100.0%), self-monitoring (54.2%) and antenatal appointment reminders (43.2%). Non-users were older, with fewer years of education, lower incomes, and higher parity (P<0.01). No association was found between “any app” use and the CAPO (6.8% in non-users compared to 6.3% in any users, OR 0.77, 95% CI: 0.48-1.25).
Conclusions:
Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. “Any app” use was not found associated with improved pregnancy outcomes, highlighting the needs for rigorous development and testing of apps before recommendation for use in clinical settings.
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