Journal
JMIR MHEALTH AND UHEALTH
Volume 5, Issue 9, Pages 32-39Publisher
JMIR PUBLICATIONS, INC
DOI: 10.2196/mhealth.8228
Keywords
pregnancy; gestational weight gain; lifestyle modification; intervention
Funding
- National Institutes of Health [U01 DK094418, 1 U54 GM104940, P30 DK072476, F31 HD084199]
- National Institutes of Health through the National Institute of Diabetes and Digestive and Kidney Diseases [U01 DK094418, U01 DK094463, U01 DK094416, 5U01 DK094466]
- National Heart, Lung, and Blood Institute [U01 HL114344, U01 HL114377]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [U01 HD072834]
- National Center for Complementary and Integrative Health (NCCIH)
- NIH Office of Research in Women's Health (ORWH)
- Office of Behavioral and Social Science Research (OBSSR)
- Indian Health Service
- Intramural Research Program of the NIDDK
- National Institute of General Medical Sciences of the National Institutes of Health [U54 GM104940]
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Background: Two-thirds of pregnant women exceed gestational weight gain (GWG) recommendations. Because excess GWG is associated with adverse outcomes for mother and child, development of scalable and cost-effective approaches to deliver intensive lifestyle programs during pregnancy is urgent. Objective: The aim of this study was to decrease the proportion of women who exceed the Institute of Medicine (IOM) 2009 GWG guidelines. Methods: In a parallel-arm randomized controlled trial, 54 pregnant women (age 18-40 years) who were overweight (n=25) or obese (n=29) were enrolled to test whether an intensive lifestyle intervention (called SmartMoms) decreased the proportion of women with excess GWG, defined as exceeding the 2009 IOM guidelines, compared to no intervention (usual care group). The SmartMoms intervention was delivered through mobile phone (remote group) or in a traditional in-person, clinic-based setting (in-person group), and included a personalized dietary intake prescription, self-monitoring weight against a personalized weight graph, activity tracking with a pedometer, receipt of health information, and continuous personalized feedback from counselors. Results: A significantly smaller proportion of women exceeded the IOM 2009 GWG guidelines in the SmartMoms intervention groups (in-person: 56%, 10/18; remote: 58%, 11/19) compared to usual care (85%, 11/13; P=.02). The remote intervention was a lower cost to participants (mean US $97, SD $6 vs mean US $347, SD $40 per participant; P<.001) and clinics (US $215 vs US $419 per participant) and with increased intervention adherence (76.5% vs 60.8%; P=.049). Conclusions: An intensive lifestyle intervention for GWG can be effectively delivered via a mobile phone, which is both cost-effective and scalable.
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