Researchers found a low-intensity, behavioral lifestyle intervention program, integrated with standard maternal care, was effective in optimizing the healthy gestational weight gain, improving physical activity in early pregnancy and in reducing post-delivery weight retention.
Monash University's Professor Helena Teede, Dr. Cate Lombard, Dr. Cheryce Harrison and a research team from the School of Public Health and Preventive Medicine in collaboration with Southern Health, assessed weight and height, physical activity, questionnaires and gestational diabetes screening in more than 220 women who participated in a four-session behavioral change lifestyle program, in contrast to those who attended a single education session.
Professor Teede said the program was effective in enabling women to improve lifestyle and adhere to recommended pregnancy weight gain in comparison to the group of women receiving education alone.
“Excessive gestational weight gain is common, especially in overweight and obese women with post pregnancy weight retention, increasing risks of diabetes and other metabolic conditions,” Professor Teede said.
“As a result of the program, the proportion of women exceeding internationally recommendation thresholds for pregnancy weight gain was significantly reduced.
"The results of this trial represent significant public health implications for mother and baby in pregnancy, and in the longer term.”
Standard measures were conducted at 12-15 weeks and 26-28 weeks gestation and six weeks post-delivery.
It is hoped the low cost and accessible program will be made available to women more broadly in the future.
The project is being supported by an International Diabetes Federation grant.
Professor Teede will officially present the findings at ENDO 2012, the 94th Annual Meeting and Expo of The Endocrine Society, June 23-26 in Houston, USA.
Gaining too much weight during pregnancy increases the risk of pre-eclampsia and gestational diabetes, and of subsequent overweight in both mother and child. At the same time, gaining less weight than recommended is associated with an increased risk of preterm birth and low birth weight."
Johanna Sandborg, doctoral student at Karolinska Institutet affiliated with Linköping University
She is first author for both of the articles that have been published in the journal JMIR mHealth and uHealth.
The researchers emphasize that the app aims to support pregnant women in achieving a healthy lifestyle during pregnancy. It provides an exercise guide, help to keep track of dietary habits and physical activity, support in changing habits, recipes and information. It has been developed by a team consisting of nutritionists, dieticians, midwives, physicians, physiotherapists, behavioral scientists, and systems developers.
In order to evaluate the effectiveness of using the app, the researchers have conducted a study in which just over 300 pregnant women in Östergötland took part. Half of them received standard care within the maternity care system (the control group), and the other half also had access to the app (the intervention group). Previous similar studies of smartphone apps have most often focused on pregnant women with overweight and obesity, in other words, those with a high body mass index (BMI). In this case, however, women from all BMI categories were included. All participants registered their physical activity and food consumption (using the Riksmaten FLEX tool from the National Food Agency, Sweden) at 14 weeks of pregnancy and approximately six months later. The researchers also measured the women's weight, height and body fat percentage on both occasions.
"The diet in the group that used the HealthyMoms app was slightly better towards the end of the pregnancy than that of the control group. Another result is that the women with overweight or obesity before pregnancy in the intervention group gained on average 1.7 kg less than those in the control group. We regard it as very positive that our app can lead to an effect similar to that seen in studies evaluating interventions that require more personnel and resources", says Marie LOF.
The researchers interviewed 19 of the women who had access to the app. In these interviews, the participants expressed that the app contained a good combination of useful tools, and that they trusted the content since the app came from a credible source.
"We now have an evidence-based, validated tool that we can use in the healthcare system, benefitting both pregnant women and personnel", says Marie LOF.
The researchers are working on how to spread the Healthy Moms app to a broader group, and to offer it in more languages than Swedish. They are working with co-workers who speak Somali and Arabic, not only to translate the information, but also to adapt the app for different groups.
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