Pregnant women’s daily patterns of well-being before and during the COVID-19 pandemic in Finland: Longitudinal monitoring through smartwatch technology

Abstract

Background Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things–based system and smartwatch technology for monitoring women during pregnancy to explore variations in stress, physical activity and sleep. The aim of this study was to examine daily patterns of well-being in pregnant women before and during the national stay-at-home restrictions related to the COVID-19 pandemic in Finland. Methods A longitudinal cohort study design was used to monitor pregnant women in their everyday settings. Two cohorts of pregnant women were recruited. In the first wave in January-December 2019, pregnant women with histories of preterm births (gestational weeks 22–36) or late miscarriages (gestational weeks 12–21); and in the second wave between October 2019 and March 2020, pregnant women with histories of full-term births (gestational weeks 37–42) and no pregnancy losses were recruited. The final sample size for this study was 38 pregnant women. The participants continuously used the Samsung Gear Sport smartwatch and their heart rate variability, and physical activity and sleep data were collected. Subjective stress, activity and sleep reports were collected using a smartphone application developed for this study. Data between February 12 to April 8, 2020 were included to cover four-week periods before and during the national stay-at-home restrictions. Hierarchical linear mixed models were exploited to analyze the trends in the outcome variables. Results The pandemic-related restrictions were associated with changes in heart rate variability: the standard deviation of all normal inter-beat intervals (p = 0.034), low-frequency power (p = 0.040) and the low-frequency/high-frequency ratio (p = 0.013) increased compared with the weeks before the restrictions. Women’s subjectively evaluated stress levels also increased significantly. Physical activity decreased when the restrictions were set and as pregnancy proceeded. The total sleep time also decreased as pregnancy proceeded, but pandemic-related restrictions were not associated with sleep. Daily rhythms changed in that the participants overall started to sleep later and woke up later. Conclusions The findings showed that Finnish pregnant women coped well with the pandemic-related restrictions and lockdown environment in terms of stress, physical activity and sleep.

The Clinical Application and Prospect of Smart Prenatal Care and Postpartum Recovery

“…Hannakaisa Niela-Vile ´ n et al reported heart rate variations, physical activity (step count), and life pressure changes (sleep duration) for known pregnant women during the COVID-19 outbreak in Finland and used a smartwatch to track all parameters. The feasibility of this approach to [ 30 ] is confirmed. Since the epidemic of COVID-19, the obstetric clinic of the Erwin Medical Center of Columbia University has begun to transform the maternity examination into a telemedicine mode.…”

“…These factors can contribute to the proper prolongation of gestational weeks, greatly reducing the premature birth rate, disability rate, and mortality rate of the fetus and greatly increasing the survival rate of pregnant women. This is of great significance to improve the quality of health care during pregnancy and promotes medical development in remote areas [ 28 , 30 , 32 ]. With the popularity of intelligent medical technology, any abnormal situation in pregnant women can be dealt with in time through intelligent medical care.…”

Women’s Depressive Symptoms during the COVID-19 Pandemic: The Role of Pregnancy

“…In a parallel study in the US, pregnant women who were engaged in more positive health behaviors were also found to have less anxiety symptoms [34]. A Finnish study monitoring pregnant women's daily patterns of heart rate variability, physical activity and sleep data showed that these variables were associated with coping better with pandemic-related restrictions [70]. Therefore, improving women's social support networks and encouraging socially distant healthy activities, such as online fitness classes suitable for pregnant women, may be targets for enhancing resilience to depression among pregnant women during the pandemic.…”

Recommending Suitable Smart Technology Applications to Support Mobile Healthcare after the COVID-19 Pandemic Using a Fuzzy Approach

“…For example, to solve the problem that the detection accuracy of a smart bracelet is not high enough, researchers have suggested that a patient must continue to record any symptom accompanied with the detection data of the smart bracelet to conduct a comprehensive judgment using special algorithms [49]. Similarly, a number of studies [50][51][52] also recommended combining smartwatch detection results with self-reported symptoms to determine whether an individual has COVID-19 after symptoms appear.…”