JMIR Publications

ABSTRACT

Background:

Approximately one in three pregnancies in the United States (US) is complicated by one or more adverse pregnancy outcomes, ranging from gestational diabetes to preterm birth. [1] This high prevalence contributes to the high rates of maternal and infant mortality in the US. The US maternal mortality rate is several times higher than that of other developed countries. [2] Intervention during the pre-pregnancy period may help reduce not only the incidence of maternal health risks, but also the associated costs for payers: every $1 invested in pre-pregnancy care may save up to $5 on infant and maternal health costs. [3]

Objective:

The digital health company, Doveras Fertility, has built a pre-pregnancy digital health platform for individuals and couples seeking to optimize their fertility potential in order to conceive. Targeting users prior to initiation of pregnancy, the platform is also able to screen, identify, and personalize recommendations to reduce risk of adverse maternal health outcomes with lifestyle interventions. We investigated the potential for the digital tool to identify individuals high-risk for adverse pregnancy outcomes prior to pregnancy.

Methods:

This paper reports on 400 people who sought Doveras’ services in a one month period between May and June, 2024 by completing a digital eligibility assessment. In this paper, self-reported data was analyzed for six healthy pre-pregnancy lifestyle factors known to influence maternal health risk and each participant was given a composite score between 0-6 to represent the number of these healthy behaviors reported. The six healthy pre-pregnancy lifestyle factors include a body mass index [BMI] 18.5 to 24.9 kg/m2, not currently smoking, 150 min/wk or more of moderate-to-vigorous physical activity, healthy eating, no daily alcohol intake, and use of a prenatal multivitamin. [1]

Results:

The majority (61%) of participants received a composite score of 3 factors or fewer and less than 5% scored 6 out of 6. These results suggest that nearly all survey participants have potential risk factors for adverse maternal outcomes and therefore the potential to adopt at least one improvement in their lifestyle behavior, which may give the opportunity to reduce their risk of adverse outcomes.

Conclusions:

By reaching this population with accessible and affordable fertility interventions during the preconception period, the digital health platform not only aims to improve fertility, but might also help to reduce maternal health adverse outcomes and associated costs.