JMIR Publications

ABSTRACT

Background:

Excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) are common pregnancy complications that have been shown to be preventable by lifestyle interventions. However, a large gap exists between research on pregnancy lifestyle interventions and translation into clinical practice. App-supported interventions might aid in overcoming previous implementation barriers. The current status in this emerging research area is unknown.

Objective:

This scoping review aimed to provide a comprehensive overview of planned, ongoing and completed studies on eHealth and mHealth app-supported lifestyle interventions in pregnancy to manage GWG and prevent GDM. The review assesses the scope of literature in the field, describes population, intervention, control, outcome, and study design (PICOS) characteristics of included studies and findings on GWG and GDM outcomes and examines app functionalities.

Methods:

The scoping review was conducted according to a pre-registered protocol and followed established frameworks. Four electronic databases and two clinical trial registers were systematically searched. All randomised and quasi-randomised controlled trials (RCTs) of app-supported lifestyle interventions in pregnancy and related qualitative and quantitative research across the different study phases were considered for inclusion. Eligible studies and reports were included until June 2022. Extracted data was compiled in descriptive analysis and reported in narrative, tabular and graphical format.

Results:

This review included 97 reports from 43 lifestyle intervention studies. The number of published reports steadily increased in recent years, of which 39% accounted for trial register entries. Studies were heterogeneous in terms of their PICOS characteristics. Most studies were conducted in high-income countries, included women with overweight or obesity, delivered multicomponent interventions during pregnancy only, and focused on diet and physical activity. Ten efficacy/effectiveness and eight pilot trials had published results on GWG, of which six efficacy/effectiveness trials observed significant intervention effects. None of the five trials reporting GDM results observed effects on GDM. The apps used within studies were mostly mHealth apps, connected to physical activity trackers and weight scales, and included self-monitoring, feedback, goal setting, prompts, and educational content.

Conclusions:

Research in this field is nascent, while effectiveness and implementability of app-supported interventions has yet to be determined. Future studies should address the remaining gaps by targeting vulnerable groups, employing a risk-adapted approach that incorporates psychological health aspects, and planning interventions that span from preconception through postpartum.