The Effectiveness of eHealth Technologies on Weight Management in Pregnant and Postpartum Women: Systematic Review and Meta-Analysis

Sherifali, Diana; Nerenberg, Kara; Wilson, Shanna; Semeniuk, Kevin; Ali, Muhammad Usman; Redman, Leanne M.; Adamo, Kristi B.

doi:10.2196/jmir.8006

Cited by 96 publications

(103 citation statements)

References 40 publications

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“…Seven of the nine systematic reviews had performed meta‐analyses, while two reported only a narrative synthesis . No systematic review included exactly the same RCTs.…”

Section: Resultsmentioning

confidence: 99%

“…Three defined this as up to 12 months after childbirth, one up to 18 months, and one up to 24 months . The remaining four systematic reviews stated that they included studies with postnatal women but did not define the postnatal period …”

Section: Resultsmentioning

confidence: 99%

“…However, three reviews included only women who either have overweight and/or have obesity, one systematic review only included women with a history of gestational diabetes, and one included only healthy women . Two did not report if they placed any restrictions on the type of postnatal women they would include …”

Section: Resultsmentioning

confidence: 99%

“…The scope of the included systematic reviews varied. Five of the reviews included studies that investigated the effectiveness of lifestyle interventions both during pregnancy and the postnatal period . However, as the review authors performed analyses for these populations separately, they were eligible for inclusion in this review of reviews.…”

Section: Resultsmentioning

confidence: 99%

“…However, as the review authors performed analyses for these populations separately, they were eligible for inclusion in this review of reviews. Two reviews focused exclusively on e‐health technology interventions . One review restricted its inclusion criteria to physical activity–only interventions while one focused on postnatal lifestyle interventions to prevent type 2 diabetes .…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

2019

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This systematic review of systematic reviews investigated the effectiveness of lifestyle weight management interventions for postnatal women. We systematically reviewed Medline (PubMed), Embase, CINAHL Plus, The Cochrane Library, and Scopus from 2000 until January 2018, to identify systematic reviews of randomized controlled trials that evaluated the effectiveness of behavioural lifestyle interventions for weight management in postnatal women. Results were summarized both descriptively and statistically using a mega meta-analysis of data from randomized controlled trials included in previous systematic reviews. Nine systematic reviews met our inclusion criteria. Overall the reviews concluded that lifestyle interventions involving physical activity and/or dietary changes resulted in a reduction in postnatal weight. Results from the overall mega meta-analysis confirmed this finding with a mean difference of −1.7 kg (95% CI, −2.3 to −1.1). Findings for subgroup analyses gave mean differences of −1.9 kg (95% CI, −2.9 to −1.0) for combined diet and physical activity interventions, −1.6 kg (95% CI, −2.1 to −1.2) for physical activity-only interventions, and −9.3 kg (95% CI, −16.5 to −2.1) for diet-only interventions (one study). Heterogeneity varied from 0% to 68%. Interventions involving lifestyle interventions appeared to be effective in reducing weight in postnatal women, although these findings should be interpreted with some caution due to statistical heterogeneity. KEYWORDS intervention, postnatal, systematic review, weight 1 | INTRODUCTIONObesity is a key contributor to many chronic co-morbidities including type 2 diabetes, cardiovascular disease, 1 stroke, and a number of types of cancers such as colorectal and breast cancer. 1-3 These conditions can be life threatening, detrimental to quality of life, and expensive to treat.The obesity epidemic is affecting all populations, including women of reproductive age. Recent national surveys reported that approximately 66%, 56%, and 58% of women in the United States of America, Australia, and England, respectively, either have overweight (body mass index [BMI] between 25 and 30 kg/m 2 ) or obesity (BMI over 30 kg/m 2 ). 4-6 This means that most women already have overweight when they become pregnant. A period of notable weight gain for many women occurs during and after pregnancy. 7,8 Studies have reported that among women who have a healthy BMI prior to pregnancy, 30% have overweight 1 year after giving birth. 9,10 Of women who have overweight prior to conception, 44% have obesity 1 year after giving birth, while 97% of women with obesity prior to pregnancy remain so at 1 year postnatally. On average, women gain about 14 to 15 kg during pregnancy, and at 1 year after birth, 5 to 9 kg is retained. 8,11 Some women are able to return to their prepregnancy weight after childbirth, but the amount of weight women retain postnatally varies considerably, and many women never lose all of the weight gained during pregnancy. [11][12][13][14][15]

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“…Seven of the nine systematic reviews had performed meta‐analyses, while two reported only a narrative synthesis . No systematic review included exactly the same RCTs.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

2019

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Effectiveness of a Text-Based Gamification Intervention to Improve Physical Activity Among Postpartum Individuals With Hypertensive Disorders of Pregnancy

et al. 2022

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IMPORTANCE Hypertensive disorders of pregnancy are associated with increased risk of cardiovascular disease, yet few interventions have targeted this population to decrease long-term risk. OBJECTIVE To determine whether a digital health intervention improves physical activity in postpartum individuals with hypertensive disorders of pregnancy. DESIGN, SETTING, AND PARTICIPANTS This 12-week randomized clinical trial enrolled postpartum individuals who delivered at the University of Pennsylvania and had a hypertensive disorder of pregnancy between October 2019 and June 2020. Analysis was intention to treat.INTERVENTIONS All participants received a wearable activity tracker, established a baseline step count, selected a step goal greater than baseline, and were randomly assigned to control or intervention. Participants in the control arm received daily feedback on goal attainment. Participants in the intervention arm were placed on virtual teams and enrolled in a game with points and levels for daily step goal achievement and informed by principles of behavioral economics. MAIN OUTCOMES AND MEASURESThe primary outcome was change in mean daily step count from baseline to 12-week follow-up. Secondary outcome was proportion of participant-days that step goal was achieved.RESULTS A total of 127 participants were randomized (64 in the control group and 63 in the intervention group) and were enrolled a mean of 7.9 weeks post partum. Participants had a mean (SD) age of 32.3 (5.6) years, 70 (55.1%) were Black, and 52 (41.9%) had Medicaid insurance. The mean (SD) baseline step count was similar in the control and intervention arms (6042 [2270] vs 6175 [1920] steps, respectively). After adjustment for baseline steps and calendar month, participants in the intervention arm had a significantly greater increase in mean daily step steps from baseline compared with the control arm (647 steps; 95% CI, 169-1124 steps; P = .009). Compared with the control arm, participants in the intervention arm achieved their steps goals on a greater proportion of participant-days during the intervention period (0.47 vs 0.38; adjusted difference 0.11; 95% CI, 0.04-0.19; P = .003). CONCLUSIONS AND RELEVANCEIn this study, a digital health intervention using remote monitoring, gamification, and social incentives among postpartum individuals at elevated cardiovascular risk significantly increased physical activity throughout 12 weeks.

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User‐centered development process of an evidence‐based mHealth intervention for psychosocially burdened families during the transition to parenthood

Vogel,

Henning,

Wolstein

et al. 2024

Mental Health Science

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Mobile health (mHealth) interventions are a promising approach to promote mothers' and fathers' health in the perinatal period. This may be particularly true for psychosocially burdened families who are poorly reached by current preventive services. Studies are needed that examine how user‐centered and evidence‐based mHealth interventions look like for this target group. The objective of this paper is to describe the iterative development process of the I‐PREGNO app intervention that aims to prevent unhealthy weight gain and to promote mental health in psychosocially burdened families during the perinatal period. The systematic content development process was divided into four stages. User needs were assessed through focus group discussions with psychosocially burdened mothers and healthcare professionals (HPs; stage I). In stage II, a prototype of the app was developed and evaluated through usability tests and a walkthrough with the target group and HPs (stage III). Finally, the behavior change techniques implemented in the app were assessed using an existing taxonomy (stage IV). The focus group discussions revealed that HPs as well as end‐users would benefit from an intervention that addresses psychosocial aspects (i.e., emotion regulation, coping) and links these to health behaviors. The identified needs of the target group during the perinatal period were combined with existing evidence‐based content and translated into 12 app modules. Most of the behavior change techniques used in these thematic modules were assigned to the clusters self‐monitoring, knowledge building, and goal planning. The I‐PREGNO app development process was guided by an iterative and user‐centered approach involving the target audience and a multidisciplinary team of experts. The findings provide valuable implications for the design and development of evidence‐based self‐guided mHealth for hard‐to‐reach groups during the transition to parenthood. The efficacy of the I‐PREGNO intervention will be evaluated in randomized controlled trials in routine care.

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The Effectiveness of eHealth Technologies on Weight Management in Pregnant and Postpartum Women: Systematic Review and Meta-Analysis

Cited by 96 publications

References 40 publications

Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

Behavioural weight management interventions for postnatal women: A systematic review of systematic reviews of randomized controlled trials

Effectiveness of a Text-Based Gamification Intervention to Improve Physical Activity Among Postpartum Individuals With Hypertensive Disorders of Pregnancy

User‐centered development process of an evidence‐based mHealth intervention for psychosocially burdened families during the transition to parenthood

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