JMIR Publications

ABSTRACT

Background:

Healthy nutritional practices and appropriate gestational weight gain (GWG) are key factors that affect maternal and fetal health. Mobile health (mHealth) interventions have shown promise in supporting positive behavioral changes during pregnancy by providing scalable, low-cost tools to complement traditional prenatal care.

Objective:

This pilot study aimed to evaluate the feasibility and acceptability of the GestaNutri application, a remote nutritional counseling program for pregnant women, by analyzing user engagement, adherence, and self-reported outcome.

Methods:

This descriptive pilot study was conducted from June 2023 to January 2025 in 90 pregnant women recruited from the Obstetrics Clinic of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. The participants received educational content via WhatsApp twice weekly for 12 weeks. Engagement was assessed using poll responses and weight/gestational age updates. Data collected included sociodemographic characteristics, health and nutritional habits, and media preferences. Statistical analyses included descriptive statistics, Kaplan–Meier survival analysis, and chi-square and Welch t-tests.

Results:

Of 90 enrolled women, 82 were included in the final analysis. Among them, 34 (41.5%) completed at least 75% of the program, whereas 48.8% discontinued participation. Most participants were primigravidas (53.6%), aged 32.2 years on average, and had higher education levels (71.3% with ≥12 years of schooling). The internet and social media were commonly used to seek nutritional information (85.5%). Among program completers, 83.3% reported improved eating habits, and 93.1% reported that they would recommend the program. Although the prevalence of GWG was not significantly different between adherent and nonadherent participants (p>0,005), a trend toward lower weight gain was observed among those who completed the program. The probability of retention decreased from 95% after 15 days to 27% after 75 days. The participants enrolled in the first trimester demonstrated higher adherence.

Conclusions:

The GestaNutri program was well received by the participants and supported healthier eating behaviors during pregnancy. Despite the limitations related to platform functionality and long-term engagement, the program demonstrated its feasibility and acceptability. These findings support the potential of remote nutritional counseling as on a complementary strategy in prenatal care. Future developments should improve the application design and tailor strategies to sustain engagement, particularly among women with lower educational levels.