Adaptive Mobile Health Intervention to Reduce Excess Gestational Weight Gain: A Cluster-Randomized Clinical Trial

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Digital Health Interventions

Background:

• Excessive gestational weight gain (GWG) affects 50% of pregnant individuals with overweight or obesity.
• High GWG is linked to adverse perinatal complications.
• There is a need for scalable, evidence-based lifestyle interventions to manage GWG.

Purpose of the Study:

• To evaluate an adaptive mobile health (mHealth) lifestyle intervention combined with standard care.
• To determine if this intervention reduces excessive GWG compared to standard care alone.

Main Methods:

• A cluster-randomized clinical trial involving pregnant patients with a prepregnancy BMI between 25.0 and 39.9.
• Intervention group received mHealth support including personalized feedback, activity tracking, educational content, and lifestyle coaching.
• Standard care group received only routine care.
• Co-primary outcomes included the weekly rate and total GWG, assessed against Institute of Medicine (IOM) guidelines.

Main Results:

• The intervention group showed a significantly lower weekly rate of GWG (0.25 kg/week vs. 0.28 kg/week).
• Fewer patients in the intervention group exceeded IOM guidelines for weekly and total GWG (51.9% vs. 60.2% and 44.1% vs. 51.2%, respectively).
• Total GWG was also significantly lower in the intervention group (9.7 kg vs. 10.6 kg).

Conclusions:

• An adaptive mHealth lifestyle intervention effectively reduced both the rate and total amount of GWG in pregnant individuals with overweight or obesity.
• This technology-leveraging approach demonstrates potential for scalable management of GWG.
• Findings support the integration of digital health tools in prenatal care to mitigate risks associated with excessive GWG.