Digital Lifestyle Interventions to Support Healthy Gestational Weight Gain: Scoping Review

Digital lifestyle interventions hold promise in supporting healthy gestational weight gain (GWG) during pregnancy. However, clarity on their key design and implementation features remains limited. The prevalence of excessive GWG and its associated maternal and infant health risks makes understanding the landscape of digital intervention characteristics critical.

This scoping review aimed to map current literature on digital lifestyle interventions designed to promote healthy GWG and to identify intervention characteristics, including behavior change techniques (BCTs), used across these interventions, with particular attention to patterns in design and implementation features across studies reporting positive outcomes.

We systematically searched PubMed, Embase, Cochrane, and Web of Science for peer-reviewed studies published between 2014 and 2024. Studies were included if they described interventions with at least 1 digital component targeting GWG. Studies on high-risk pregnancies, nonhuman participants, protocols without results, abstracts, gray literature, and non-English publications were excluded. Data extraction covered study characteristics, theoretical frameworks, timing, duration, frequency, delivery modes, and BCTs applied. The landscape of intervention characteristics was mapped, including descriptive analysis of features that appeared across different study outcomes.

A total of 44 studies met the inclusion criteria: 23 primary data articles (pilot studies, randomized controlled trials, etc) and 21 secondary data articles (meta-analyses, systematic reviews, etc). Primary studies showed that interventions were more likely to achieve intended outcomes when they started earlier, lasted longer, and combined digital and in-person components. Five BCTs were commonly present across interventions achieving positive outcomes: goal setting (outcome; 71%), discrepancy between current behavior and goal (43%), self-monitoring of behavior (86%), social support (unspecified; 71%), and credible source (71%). Secondary studies supported these findings, identifying several helpful features: starting before midpregnancy, long duration with high intensity, in-person contact, and BCTs related to goal setting, action planning, feedback on, and monitoring of behavior. However, primary studies showed gaps in reporting practices, with many details lacking about design and implementation features, such as BCTs. This converged with secondary studies reporting insufficient detail in the reviewed primary literature, limiting interpretation and replication potential.

This scoping review maps digital interventions for GWG and identifies key patterns in intervention design and implementation. Evidence suggests that interventions may be more promising when combining digital delivery with in-person components and incorporating BCTs related to goal setting, self-monitoring, and social support. This review provides a comprehensive mapping of BCT usage and other intervention features, highlighting approaches associated with positive outcomes. However, significant gaps in reporting practices limit evidence synthesis. The findings can inform the design of digital interventions for managing GWG by identifying potentially successful design and implementation features. Future research should prioritize standardized reporting practices and evaluate interventions in underserved populations, including health care desert communities, to enhance the evidence base.