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#Grand Rounds

Can a Smartphone ‘Diet and Activity’ App Impact Gestational Weight Gain?

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BACKGROUND AND PURPOSE:

  • Research regarding interventions to prevent excess gestational weight gain are needed
    • Benefits of traditional antenatal weight control strategies have been inconsistent
  • Horn et al. (American Journal of Preventive Medicine, 2018) assessed whether an antenatal diet and lifestyle smartphone app could prevent excess gestational weight gain

METHODS:

  • Randomized clinical trial (RCT)
    • Overweight and obese ethnically diverse pregnant women (IOM guidelines – see ‘Related ObG Topics’ below)
    • MAMA-DASH (minor modifications to the dietitian-led Dietary Approaches to Stop Hypertension)
  • Randomization at 16 weeks to either
    • Intervention: Commercially available smartphone application for self-monitoring, text message prompts and email reminders encouraging adherence
    • Control: E-mailed biweekly newsletters and publicly available maternity website links
  • Primary outcome
    • Gestational weight gain measured at baseline, 24 weeks, and 35w0d-36w6d
  • Secondary outcomes included
    • Weekly rate of gestational weight gain | Newborn anthropometrics | Maternal diet quality | Physical activity | Blood pressure

RESULTS:

  • 140 in intervention | 141 in usual care
    • BMI 25 to <40
    • Age range 18–40 years
    • 37% were non-white
  • At 35 weeks, the app was superior at limiting weight gain compared to the control arm (p=0.02)
    • Intervention group: 10 kg
    • Control group: 12 kg
  • Most participants exceeded guidelines but this occurred significantly less often in the app group (p=0.004)
    • Intervention group: 69%
    • Control group: 85%
  • The rate of weight gain was 0.4 in the intervention group vs 0.5 kg/week in the control group
  • Cesarean sections were 40% in the intervention group vs 37% in the intervention group (p=0.03)
  • No significant differences were noted in birth weight, percentage body fat, or adverse pregnancy outcomes
  • Nutrient quality improved without an adverse impact on rate of prematurity

CONCLUSION:

  • The authors recommend further research to determine the association with increased cesarean sections
  • Technology-enhanced DASH diet did positively impact gestational weight gain
  • IOM goals were not met by most participants and preconception obesity prevention strategies are required

Learn More – Primary Sources:

Dietary Approaches to Stop Hypertension Diet and Activity to Limit Gestational Weight: Maternal Offspring Metabolics Family Intervention Trial, a Technology Enhanced Randomized Trial

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Related ObG Topics:

Practical obstetrics info for your women's healthcare practice
Recommended Weight Gain and Obesity Management in Pregnancy
Maternal Overweight, Obesity and Congenital Malformations – How Strong is the Link?

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