Semin Reprod Med 2016; 34(02): e22-e27
DOI: 10.1055/s-0036-1583533
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Delivery of Dietary and Lifestyle Interventions in Pregnancy: is it Time to Promote the Use of Electronic and Mobile Health Technologies?

Cecelia M. O'Brien
1   School of Paediatrics and Reproductive Health, and Robinson Research Institute, University of Adelaide, Adelaide, Australia
,
Courtney Cramp
1   School of Paediatrics and Reproductive Health, and Robinson Research Institute, University of Adelaide, Adelaide, Australia
,
Jodie M. Dodd
1   School of Paediatrics and Reproductive Health, and Robinson Research Institute, University of Adelaide, Adelaide, Australia
2   Department of Perinatal Medicine, Women's and Babies Division, Women's and Children's Hospital, Adelaide, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
12 May 2016 (online)

Abstract

Fifty percent of women who enter pregnancy are overweight or obese, increasing complications for both the mother and the infant, along with significant burden on individuals and the health care system. Pregnancy represents a “teachable moment” in a woman's life, however, antenatal interventions focusing on improving dietary and physical activity patterns have been associated with modest behavior change. There are many barriers that need to be overcome, including lack of knowledge, access and time pressures. Advancing mobile and electronic health technologies may represent an adjunct tool to support traditional face-to-face consultations and facilitate behavior change, but further rigorous evaluation of the technologies and their impact on health outcomes is required. Well-designed antenatal intervention trials with particular attention to the structure and method of information provision are required to further assess the feasibility of such technology.

 
  • References

  • 1 Organisation WH. WHO Fact Sheet Obesity and Overweight. In, 2015
  • 2 Chu SY, Kim SY, Bish CL. Prepregnancy obesity prevalence in the United States, 2004-2005. Matern Child Health J 2009; 13 (5) 614-620
  • 3 Scheil W, Scott J, Catcheside B, Sage L, Kennare R. Pregnancy outcome in South Australia 2012. In: Health POUS, (ed). Adelaide: Government of South Australia; 2014
  • 4 Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet 2006; 93 (3) 269-274
  • 5 Crane JM, Murphy P, Burrage L, Hutchens D. Maternal and perinatal outcomes of extreme obesity in pregnancy. J Obstet Gynaecol Can 2013; 35 (7) 606-611
  • 6 Enquiries CfMaC. Maternal Obesity in the UK: findings from a national project. CMACE; London: 2010
  • 7 Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989-2007. Int J Obes 2010; 34 (3) 420-428
  • 8 Abenhaim HA, Kinch RA, Morin L, Benjamin A, Usher R. Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes. Arch Gynecol Obstet 2007; 275 (1) 39-43
  • 9 Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust 2006; 184 (2) 56-59
  • 10 Dodd JM, Grivell RM, Nguyen A-M, Chan A, Robinson JS. Maternal and perinatal health outcomes by body mass index category. Aust N Z J Obstet Gynaecol 2011; 51 (2) 136-140
  • 11 Cedergren MI. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol 2004; 103 (2) 219-224
  • 12 Cnattingius S, Bergström R, Lipworth L, Kramer MS. Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998; 338 (3) 147-152
  • 13 Retnakaran R, Qi Y, Sermer M, Connelly PW, Hanley AJ, Zinman B. Glucose intolerance in pregnancy and future risk of pre-diabetes or diabetes. Diabetes Care 2008; 31 (10) 2026-2031
  • 14 Hedderson MM, Gunderson EP, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol 2010; 115 (3) 597-604
  • 15 Shah BR, Retnakaran R, Booth GL. Increased risk of cardiovascular disease in young women following gestational diabetes mellitus. Diabetes Care 2008; 31 (8) 1668-1669
  • 16 Jónsdóttir LS, Arngrímsson R, Geirsson RT, Sigvaldason H, Sigfússon N. Death rates from ischemic heart disease in women with a history of hypertension in pregnancy. Acta Obstet Gynecol Scand 1995; 74 (10) 772-776
  • 17 Fraser A, Tilling K, Macdonald-Wallis C , et al. Associations of gestational weight gain with maternal body mass index, waist circumference, and blood pressure measured 16 y after pregnancy: the Avon Longitudinal Study of Parents and Children (ALSPAC). Am J Clin Nutr 2011; 93 (6) 1285-1292
  • 18 Tikellis G, Ponsonby AL, Wells JC, Pezic A, Cochrane J, Dwyer T. Maternal and infant factors associated with neonatal adiposity: results from the Tasmanian Infant Health Survey (TIHS). Int J Obes 2012; 36 (4) 496-504
  • 19 Fraser A, Tilling K, Macdonald-Wallis C , et al. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation 2010; 121 (23) 2557-2564
  • 20 Cedergren MI. Optimal gestational weight gain for body mass index categories. Obstet Gynecol 2007; 110 (4) 759-764
  • 21 Nohr EA, Bech BH, Davies MJ, Frydenberg M, Henriksen TB, Olsen J. Prepregnancy obesity and fetal death: a study within the Danish National Birth Cohort. Obstet Gynecol 2005; 106 (2) 250-259
  • 22 Kiel DW, Dodson EA, Artal R, Boehmer TK, Leet TL. Gestational weight gain and pregnancy outcomes in obese women: how much is enough?. Obstet Gynecol 2007; 110 (4) 752-758
  • 23 Thangaratinam S, Rogozinska E, Jolly K , et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012; 344: e2088
  • 24 Gardner B, Wardle J, Poston L, Croker H. Changing diet and physical activity to reduce gestational weight gain: a meta-analysis. Obes Rev 2011; 12 (7) e602-e620
  • 25 Hill B, Skouteris H, Fuller-Tyszkiewicz M. Interventions designed to limit gestational weight gain: a systematic review of theory and meta-analysis of intervention components. Obes Rev 2013; 14 (6) 435-450
  • 26 Inskip H, Baird J, Barker M , et al. Influences on adherence to diet and physical activity recommendations in women and children: insights from six European studies. Ann Nutr Metab 2014; 64 (3–4) 332-339
  • 27 Phelan S. Pregnancy: a “teachable moment” for weight control and obesity prevention. Am J Obstet Gynecol 2010; 202 (2) 135.e1-135.e8
  • 28 Nitert MD, Foxcroft KF, Lust K , et al. Overweight and obesity knowledge prior to pregnancy: a survey study. BMC Pregnancy Childbirth 2011; 11: 96
  • 29 Shub A, Huning EY, Campbell KJ, McCarthy EA. Pregnant women's knowledge of weight, weight gain, complications of obesity and weight management strategies in pregnancy. BMC Res Notes 2013; 6: 278
  • 30 Sui Z, Turnbull DA, Dodd JM. Overweight and obese women's perceptions about making healthy change during pregnancy: a mixed method study. Matern Child Health J 2013; 17 (10) 1879-1887
  • 31 Smith D, Lavender T. The maternity experience for women with a body mass index ≥ 30 kg/m2: a meta-synthesis. BJOG 2011; 118 (7) 779-789
  • 32 Willcox JC, Campbell KJ, van der Pligt P, Hoban E, Pidd D, Wilkinson S. Excess gestational weight gain: an exploration of midwives' views and practice. BMC Pregnancy Childbirth 2012; 12 (102) 102
  • 33 Tovar A, Chasan-Taber L, Bermudez OI, Hyatt RR, Must A. Knowledge, attitudes, and beliefs regarding weight gain during pregnancy among Hispanic women. Matern Child Health J 2010; 14 (6) 938-949
  • 34 Dodd JM, Turnbull D, McPhee AJ , et al; LIMIT Randomised Trial Group. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ 2014; 348: g1285
  • 35 Poston L, Bell R, Croker H , et al; UPBEAT Trial Consortium. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol 2015; 3 (10) 767-777
  • 36 Chiswick C, Reynolds RM, Denison F , et al. Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol 2015; 3 (10) 778-786
  • 37 Dodd JM, Cramp C, Sui Z , et al; LIMIT Randomised Trial Group. The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial. BMC Med 2014; 12: 161 http://www.biomedcentral.com/1741-7015/12/161
  • 38 Shaw K, O'Rourke P, Del Mar C, Kenardy J. Psychological interventions for overweight or obesity. (Review) Cochrane Database Syst Rev 2005; (2) CD003818
  • 39 Szmeja MA, Cramp C, Grivell RM, Deussen AR, Yelland LN, Dodd JM. Use of a DVD to provide dietary and lifestyle information to pregnant women who are overweight or obese: a nested randomised trial. BMC Pregnancy Childbirth 2014; 14: 409
  • 40 King AB, Wolfe GS, Armstrong DU. Evaluation of a patient education booklet (SimpleStart) effect on postprandial glucose control in type 2 diabetes. Diabetes Technol Ther 2007; 9 (3) 241-245
  • 41 Taylor JA, Kwan-Gett TS, McMahon Jr EMJ. Effectiveness of an educational intervention in modifying parental attitudes about antibiotic usage in children. Pediatrics 2003; 111 (5 Pt 1) e548-e554
  • 42 Farnworth A, Robson SC, Thomson RG, Watson DB, Murtagh MJ. Decision support for women choosing mode of delivery after a previous caesarean section: a developmental study. Patient Educ Couns 2008; 71 (1) 116-124
  • 43 Hope N, Rombauts L. Can an educational DVD improve the acceptability of elective single embryo transfer? A randomized controlled study. Fertil Steril 2010; 94 (2) 489-495
  • 44 Hausenblas HA, Brewer BW, Van Raalte JL , et al. Development and evaluation of a multimedia CD-ROM for exercise during pregnancy and postpartum. Patient Educ Couns 2008; 70 (2) 215-219
  • 45 Organisation WH. Obesity Fact Sheet. http://www.who.int/mediacentre/factsheets/fs311/en/" 2014
  • 46 Organisation WH. Global Strategy on Diet, Physical Activity and Health: Childhood Overweight and Obesity In. Geneva, 2011
  • 47 Okorodudu DE, Bosworth HB, Corsino L. Innovative interventions to promote behavioral change in overweight or obese individuals: A review of the literature. Ann Med 2015; 47 (3) 179-185
  • 48 Capozzi D, Lanzola G. Utilizing information technologies for lifelong monitoring in diabetes patients. J Diabetes Sci Tech 2011; 5 (1) 55-62
  • 49 Godwin ZR, Bockhold JC, Webster L, Falwell S, Bomze L, Tran NK. Development of novel smart device based application for serial wound imaging and management. Burns 2013; 39 (7) 1395-1402
  • 50 Milanese S, Gordon S, Buettner P , et al. Reliability and concurrent validity of knee angle measurement: smart phone app versus universal goniometer used by experienced and novice clinicians. Man Ther 2014; 19 (6) 569-574
  • 51 Zvornicanin E, Zvornicanin J, Hadziefendic B. The Use of Smart phones in Ophthalmology. Acta Inform Med 2014; 22 (3) 206-209
  • 52 Patrick K, Raab F, Adams MA , et al. A text message-based intervention for weight loss: randomized controlled trial. J Med Internet Res 2009; 11 (1) e1
  • 53 Haapala I, Barengo NC, Biggs S, Surakka L, Manninen P. Weight loss by mobile phone: a 1-year effectiveness study. Public Health Nutr 2009; 12 (12) 2382-2391
  • 54 Carter MC, Burley VJ, Nykjaer C, Cade JE. Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. J Med Internet Res 2013; 15 (4) e32
  • 55 Brindal E, Hendrie G, Freyne J, Coombe M, Berkovsky S, Noakes M. Design and pilot results of a mobile phone weight-loss application for women starting a meal replacement programme. J Telemed Telecare 2013;
  • 56 Hutchesson MJ, Rollo ME, Krukowski R , et al. eHealth interventions for the prevention and treatment of overweight and obesity in adults: a systematic review with meta-analysis. Obes Rev 2015; 16 (5) 376-392
  • 57 Derbyshire E, Dancey D. Smartphone Medical Applications for Women's Health: What Is the Evidence-Base and Feedback?. Int J Telemed Appl 2013; 2013: 782074
  • 58 Donaldson EL, Fallows S, Morris M. A text message based weight management intervention for overweight adults. J Hum Nutr Diet 2014; 27 (Suppl. 02) 90-97
  • 59 Napolitano MA, Hayes S, Bennett GG, Ives AK, Foster GD. Using Facebook and text messaging to deliver a weight loss program to college students. Obesity (Silver Spring) 2013; 21 (1) 25-31
  • 60 Norman GJ, Kolodziejczyk JK, Adams MA, Patrick K, Marshall SJ. Fruit and vegetable intake and eating behaviors mediate the effect of a randomized text-message based weight loss program. Prev Med 2013; 56 (1) 3-7
  • 61 Park MJ, Kim HS. Evaluation of mobile phone and Internet intervention on waist circumference and blood pressure in post-menopausal women with abdominal obesity. Int J Med Inform 2012; 81 (6) 388-394
  • 62 Shapiro JR, Koro T, Doran N , et al. Text4Diet: a randomized controlled study using text messaging for weight loss behaviors. Prev Med 2012; 55 (5) 412-417
  • 63 Tang J, Abraham C, Stamp E, Greaves C. How can weight-loss app designers' best engage and support users? A qualitative investigation. Br J Health Psychol 2015; 20 (1) 151-171
  • 64 Kaewkungwal J, Singhasivanon P, Khamsiriwatchara A, Sawang S, Meankaew P, Wechsart A. Application of smart phone in “Better Border Healthcare Program”: a module for mother and child care. BMC Med Inform Decis Mak 2010; 10: 69
  • 65 Hearn L, Miller M, Lester L. Reaching perinatal women online: the Healthy You, Healthy Baby website and app. J Obes 2014; 2014: 573928
  • 66 Tripp N, Hainey K, Liu A , et al. An emerging model of maternity care: smartphone, midwife, doctor?. Women Birth 2014; 27 (1) 64-67
  • 67 Evans WD, Wallace JL, Snider J. Pilot evaluation of the text4baby mobile health program. BMC Public Health 2012; 12: 1031
  • 68 Jareethum R, Titapant V, Chantra T, Sommai V, Chuenwattana P, Jirawan C. Satisfaction of healthy pregnant women receiving short message service via mobile phone for prenatal support: A randomized controlled trial. J Med Assoc Thai 2008; 91 (4) 458-463
  • 69 Naughton F, Prevost AT, Gilbert H, Sutton S. Randomized controlled trial evaluation of a tailored leaflet and SMS text message self-help intervention for pregnant smokers (MiQuit). Nicotine Tob Res 2012; 14 (5) 569-577
  • 70 Harrison CL, Lombard CB, Teede HJ. Limiting postpartum weight retention through early antenatal intervention: the HeLP-her randomised controlled trial. Int J Behav Nutr Phys Act 2014; 11: 134
  • 71 Herring SJ, Cruice JF, Bennett GG, Davey A, Foster GD. Using technology to promote postpartum weight loss in urban, low-income mothers: a pilot randomized controlled trial. J Nutr Educ Behav 2014; 46 (6) 610-615
  • 72 Knight-Agarwal C, Davis DL, Williams L, Davey R, Cox R, Clarke A. Development and Pilot Testing of the Eating4two Mobile Phone App to Monitor Gestational Weight Gain. JMIR Mhealth Uhealth 2015; 3 (2) e44
  • 73 Pollak KI, Alexander SC, Bennett G , et al. Weight-related SMS texts promoting appropriate pregnancy weight gain: a pilot study. Patient Educ Couns 2014; 97 (2) 256-260
  • 74 Soltani H, Duxbury AM, Arden MA, Dearden A, Furness PJ, Garland C. Maternal Obesity Management Using Mobile Technology: A Feasibility Study to Evaluate a Text Messaging Based Complex Intervention during Pregnancy. J Obes 2015; 2015: 814830
  • 75 Redman LM, Phelan S. It is time to take preconception health seriously. Obesity (Silver Spring) 2016; 24 (2) 279
  • 76 Steegers-Theunissen RP, Steegers EA. Embryonic health: new insights, mHealth and personalised patient care. Reprod Fertil Dev 2015; 27: 712-715
  • 77 Funk KL, LeBlanc ES, Vesco KK, Stevens VJ. Women's attitudes towards a pre-conception healthy lifestyle programme. Clin Obes 2015; 5 (2) 67-71
  • 78 Legro RS, Dodson WC, Kris-Etherton PM , et al. Randomized Controlled Trial of Preconception Interventions in Infertile Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab 2015; 100 (11) 4048-4058
  • 79 Opray N, Grivell RM, Deussen AR, Dodd JM. Directed preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese. Cochrane Database Syst Rev 2015; 7: CD010932