Effect of Technology-Supported Interventions on Prenatal Gestational Weight Gain, Physical Activity, and Healthy Eating Behaviors: a Systematic Review and Meta-analysis

Leonard, Krista S.; Evans, M. Blair; Oravecz, Zita; Smyth, Joshua M.; Downs, Danielle Symons

doi:10.1007/s41347-020-00155-6

Cited by 6 publications

(3 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Exercising at vigorous intensity is in accordance with recent suggestions for healthy pregnant women [46,47]. MOT had a high intervention attendance, but even though MOT contained face-to-face counseling, text messaging, activity tracker use, and behavior change techniques as recommended [13,48,49], we found no effect on MVPA compared with CON. The processes behind this finding are currently being assessed via mixed methods.…”

Section: Effectiveness Of Pa Interventions On Pa Level In Pregnant Womensupporting

confidence: 86%

Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women’s Physical Activity Level: FitMum - Randomized Controlled Trial

Knudsen¹,

Alomairah²,

Roland³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

Background Physical activity (PA) during pregnancy is an effective and safe way to improve maternal health in uncomplicated pregnancies. However, compliance with PA recommendations remains low among pregnant women. Objective The purpose of this study was to evaluate the effects of offering structured supervised exercise training (EXE) or motivational counseling on PA (MOT) during pregnancy on moderate-to-vigorous intensity physical activity (MVPA) level. Additionally, complementary measures of PA using the Pregnancy Physical Activity Questionnaire (PPAQ) and gold standard doubly labeled water (DLW) technique were investigated. The hypotheses were that both EXE and MOT would increase MVPA in pregnancy compared with standard care (CON) and that EXE would be more effective than MOT. In addition, the association between MVPA and the number of sessions attended was explored. Methods A randomized controlled trial included 220 healthy, inactive pregnant women with a median gestational age of 12.9 (IQR 9.4-13.9) weeks. A total of 219 women were randomized to CON (45/219), EXE (87/219), or MOT (87/219). The primary outcome was MVPA (minutes per week) from randomization to the 29th gestational week obtained by a wrist-worn commercial activity tracker (Vivosport, Garmin International). PA was measured by the activity tracker throughout pregnancy, PPAQ, and DLW. The primary outcome analysis was performed as an analysis of covariance model adjusting for baseline PA. Results The average MVPA (minutes per week) from randomization to the 29th gestational week was 33 (95% CI 18 to 47) in CON, 50 (95% CI 39 to 60) in EXE, and 40 (95% CI 30 to 51) in MOT. When adjusted for baseline MVPA, participants in EXE performed 20 (95% CI 4 to 36) minutes per week more MVPA than participants in CON (P=.02). MOT was not more effective than CON; EXE and MOT also did not differ. MVPA was positively associated with the number of exercise sessions attended in EXE from randomization to delivery (P=.04). Attendance was higher for online (due to COVID-19 restrictions) compared with physical exercise training (P=.03). Adverse events and serious adverse events did not differ between groups. Conclusions Offering EXE was more effective than CON to increase MVPA among pregnant women, whereas offering MOT was not. MVPA in the intervention groups did not reach the recommended level in pregnancy. Changing the intervention to online due to COVID-19 restrictions did not affect MVPA level but increased exercise participation. Trial Registration ClinicalTrials.gov NCT03679130; https://clinicaltrials.gov/ct2/show/NCT03679130 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-043671

show abstract

Section: Effectiveness Of Pa Interventions On Pa Level In Pregnant Womensupporting

confidence: 86%

Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women’s Physical Activity Level: FitMum - Randomized Controlled Trial

Knudsen¹,

Alomairah²,

Roland³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Similarly, in another meta-analysis of 21 studies, the researchers reported that women receiving support gained less weight with telehealth applications during pregnancy compared to women without support. 46 These findings show that the use of telehealth in pregnancy may be useful in terms of improving women's adoption of a healthy lifestyle that includes weight control and healthy eating.…”

Section: Discussionmentioning

confidence: 88%

The impact of telehealth applications on pregnancy outcomes and costs in high-risk pregnancy: A systematic review and meta-analysis

2022

View full text Add to dashboard Cite

Introduction Telehealth is an applicable, acceptable, cost-effective, easily accessible, and speedy method for pregnant women. This study aimed to examine the impact of telehealth applications on pregnancy outcomes and costs in high-risk pregnancies. Methods Studies were selected from PubMed, Science Direct, Web of Science, EBSCO, Scopus, and Clinical Key databases according to the inclusion and exclusion criteria from January to February 2021. Cochrane risk-of-bias tools were used in the quality assessment of the studies. Results Four observational and eight randomized controlled studies were included in this meta-analysis (telehealth: 135,875, control: 94,275). It was seen that the number of ultrasound ( p < 0.01) and face-to-face visits ( p < 0.01), fasting insulin ( p < 0.01), hemoglobin A1C before delivery ( p < 0.01), and emergency cesarean section rates ( p = 0.05) were lower in the telehealth group. In the telehealth group, the women's use of antenatal corticosteroids ( p = 0.03) and hypoglycemic medication at delivery ( p = 0.03), the total of nursing interventions ( p < 0.01), compliance with actual blood glucose measurements ( p < 0.01), induction intervention at delivery ( p = 0.003), and maternal mortality ( p < 0.001) rates were higher. Two groups were similar in terms of the use of medical therapy, total gestational weight gain, health problems related to pregnancy, mode and complications of delivery, maternal intensive care unit admission, fetal-neonatal growth and development, neonatal health problems and mortality, follow-up, and care costs. Discussion Telehealth and routine care yielded similar maternal/neonatal health and cost outcomes. It can be said that telehealth is a safe technique to work with in the management of high-risk pregnancies.

show abstract

“…Another systematic review and meta-analysis of 21 randomized controlled trials assessing the effects of technology-supported interventions on GWG found that these interventions had small effects on GWG, energy intake, eating behaviors, and PA. However, technology-supported interventions that included tracking tools, daily monitoring using devices, and face-to-face sessions were associated with slightly larger effects, particularly for PA [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

A Web-Based mHealth Intervention With Telephone Support to Increase Physical Activity Among Pregnant Patients With Overweight or Obesity: Feasibility Randomized Controlled Trial

Thomas¹,

Xu²,

Sridhar³

et al. 2022

JMIR Form Res

View full text Add to dashboard Cite

Background Pregnant patients with overweight or obesity are at high risk for perinatal complications. Excess gestational weight gain (GWG) further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior change to reduce excess GWG, reduce intervention costs, and increase scalability by improving access. Objective This study aimed to test the acceptability and feasibility of a pilot mHealth lifestyle intervention for pregnant patients with overweight or obesity to promote moderate intensity physical activity (PA), encourage guideline-concordant GWG, and inform the design of a larger pragmatic cluster randomized controlled trial. Methods We conducted a mixed methods acceptability and feasibility randomized controlled trial among pregnant patients with a prepregnancy BMI of 25 to 40 kg/m2. Patients with singletons at 8 to 15 weeks of gestation who were aged ≥21 years and had Wi-Fi access were recruited via email from 2 clinics within Kaiser Permanente Northern California and randomized to receive usual prenatal care or an mHealth lifestyle intervention. Participants in the intervention arm received wireless scales, access to an intervention website, activity trackers to receive automated feedback on weight gain and activity goals, and monthly calls from a lifestyle coach. Surveys and focus groups with intervention participants assessed intervention satisfaction and ways to improve the intervention. PA outcomes were self-assessed using the Pregnancy Physical Activity Questionnaire, and GWG was assessed using electronic health record data for both arms. Results Overall, 33 patients were randomly assigned to the intervention arm, and 35 patients were randomly assigned to the usual care arm. All participants in the intervention arm weighed themselves at least once a week, compared with 20% (7/35) of the participants in the usual care arm. Participants in the intervention arm wore the activity tracker 6.4 days per week and weighed themselves 5.3 times per week, and 88% (29/33) of them rated the program “good to excellent.” Focus groups found that participants desired more nutrition-related support to help them manage GWG and would have preferred an app instead of a website. Participants in the intervention arm had a 23.46 metabolic equivalent of task hours greater change in total PA per week and a 247.2-minute greater change in moderate intensity PA per week in unadjusted models, but these effects were attenuated in adjusted models (change in total PA: 15.55 metabolic equivalent of task hours per week; change in moderate intensity PA: 199.6 minutes per week). We found no difference in total GWG (mean difference 1.14 kg) compared with usual care. Conclusions The pilot mHealth lifestyle intervention was feasible, highly acceptable, and promoted self-monitoring. Refined interventions are needed to effectively affect PA and GWG among pregnant patients with overweight or obesity. Trial Registration ClinicalTrials.gov NCT03936283; https://clinicaltrials.gov/ct2/show/NCT03936283

show abstract

Effect of Technology-Supported Interventions on Prenatal Gestational Weight Gain, Physical Activity, and Healthy Eating Behaviors: a Systematic Review and Meta-analysis

Cited by 6 publications

References 59 publications

Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women’s Physical Activity Level: FitMum - Randomized Controlled Trial

Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women’s Physical Activity Level: FitMum - Randomized Controlled Trial

The impact of telehealth applications on pregnancy outcomes and costs in high-risk pregnancy: A systematic review and meta-analysis

A Web-Based mHealth Intervention With Telephone Support to Increase Physical Activity Among Pregnant Patients With Overweight or Obesity: Feasibility Randomized Controlled Trial

Contact Info

Product

Resources

About