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mHealth use during pregnancy: A systematic review

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International Journal of Gynecology & Obstetrics
Authors:
Mei‐Fei Hsieh
Mei‐Fei Hsieh
Mei‐Fei Hsieh
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Valerie Slavin
Valerie Slavin
Valerie Slavin
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Mei‐Zen Huang
Mei‐Zen Huang
Mei‐Zen Huang
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Hsiu‐Hung Wang
Hsiu‐Hung Wang
Hsiu‐Hung Wang
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Abstract and Figures

Background The use of mobile health (mHealth) therapies during pregnancy has aroused increasing attention. The objective of this study was to systematically evaluate the effects of mHealth interventions on pregnant women's quality of life and pregnancy outcomes, with specific attention to psychosocial health. Search Strategy We performed a systematic review of the literature published between 2013 and 2023 from eight databases. Selection Criteria English‐language original articles released in 2013–2023 on the use of modern technology in caring for pregnant women, and articles with the subject matter pregnant and financially independent women. Data Collection and Analysis The data focused on the intervention parameters defined as those that increase the frequency of medical examination attendance, including follow‐up, and improve the level of health education, compliance with medical preventive procedures, and participation in health events. Main Results Our results demonstrated that the quality of life of pregnant women using mHealth improved in the specified areas. These interventions, including various tools such as text messaging, voice calls, mobile applications, and wearable devices, have been shown to improve maternal and fetal health outcomes, particularly in low‐resource settings, by providing educational resources, monitoring maternal and fetal health status, and increasing adherence to treatment plans. Conclusion The implementation of mHealth interventions during pregnancy can enhance the overall quality of healthcare and provide more promising pregnancy outcomes. Further investigation is needed to find the optimum types of mHealth intervention and how they can be integrated into existing healthcare systems.
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Int J Gynecol Obstet. 2025;00:1–7.  
|
 1wileyonlinelibrary.com/journal/ijgo
1 |  INTRODUCTIO N
Several factors can affect the quality of life (QOL) of preg-
nant women in all three trimesters.1 The physical domain ap-
pears to be the most affected area, particularly compared with
non- pregnant women of the same age. Some pregnant women
experience reduced physical activity and a lower pain threshold
than non- pregnant women.1,2 Physical symptoms, such as nausea
and vomiting, epigastralgia, reflux, shortness of breath, dizziness,
back pain, and sleep problems, are common during pregnancy and
Received: 8 November 2024 
|
 Revised: 22 April 2025 
|
 Accepted: 29 April 2025
DOI: 10.1002/ijgo.70205
REVIEW ARTICLE
Obstetrics
mHealth use during pregnancy: A systematic review
Mei- Fei Hsieh1,2 | Valerie Slavin3 | Mei- Zen Huang4 | Hsiu- Hung Wang5 |
Hsiu- Fen Hsieh5
© 2025 International Fe deration of Gy necolog y and Obstet rics.
1School of Nursing, Kaohsiung Medical
University, Kaohsiung, Sanmin District ,
Taiwan
2Deputy Director Quality Management
Center, Chi Mei Medical Center Liouying,
Tainan, Liouying District, Taiwan
3Queensland Health, Griffith University,
Queensland Government | Griffith
University, Brisbane, Queensland,
Australia
4Depar tment of Nur sing, Natio nal Tainan
Junior College of Nursing, National Tainan
Junior College of Nursing, Tainan, West
Centra l Distric t, Taiwan
5Depar tment of Nur sing, Natio nal Tainan
Junior College of Nursing, Kaohsiung
Medical University, Kaohsiung, Sanmin
District, Taiwan
Correspondence
Hsiu- Hung Wang, Professor Emerit us,
College of N ursing, Kaohsiung Medical
University, 100, Shih- Chuan 1s t Road,
Kaohsiung, 80708, Taiwan.
Email: hhwang@kmu.edu.tw
Abstract
Background: The use of mobile health (mHealth) therapies during pregnancy has
aroused increasing attention. The objective of this study was to systematically eval-
uate the effects of mHealth interventions on pregnant women's quality of life and
pregnancy outcomes, with specific attention to psychosocial health.
Search Strategy: We performed a systematic review of the literature published be-
tween 2013 and 2023 from eight databases.
Selection Criteria: English- language original articles released in 2013–2023 on the
use of modern technology in caring for pregnant women, and articles with the subject
matter pregnant and financially independent women.
Data Collection and Analysis: The data focused on the intervention parameters de-
fined as those that increase the frequency of medical examination attendance, includ-
ing follow- up, and improve the level of health education, compliance with medical
preventive procedures, and participation in health events.
Main Results: Our results demonstrated that the quality of life of pregnant women
using mHealth improved in the specified areas. These interventions, including various
tools such as text messaging, voice calls, mobile applications, and wearable devices,
have been shown to improve maternal and fetal health outcomes, particularly in low-
resource settings, by providing educational resources, monitoring maternal and fetal
health status, and increasing adherence to treatment plans.
Conclusion: The implementation of mHealth interventions during pregnancy can
enhance the overall quality of healthcare and provide more promising pregnancy
outcomes. Further investigation is needed to find the optimum types of mHealth in-
tervention and how they can be integrated into existing healthcare systems.
KEY WORDS
maternal health, mobile health, pregnancy outcomes, qualit y of life, web- based intervention
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Moise et al 2023 Digital Technologies for pregancy support during the coronavirus crisis
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Full-text available
  • Mar 2023
Background Timely access to essential obstetric and gynecologic healthcare is an effective method for improving maternal and neonatal outcomes; however, the COVID-19 pandemic impacted pregnancy care globally. In this global scoping review, we select and investigate peer-reviewed empirical studies related to mHealth and telehealth implemented during the pandemic to support pregnancy care and to improve birth outcomes. Methods We searched MEDLINE and PubMed, Scopus, CINAHL and Web of Science for this Review because they include peer-reviewed literature in the disciplines of behavioral sciences, medicine, clinical sciences, health-care systems, and psychology. Because our investigative searches reviewed that there is considerable ‘grey literature’ in this area; we did not restrict our review to any study design, methods, or place of publication. In this Review, peer-reviewed preprints were comparable to published peer-reviewed articles, with relevant articles screened accordingly. Results The search identified 1851 peer reviewed articles, and after removal of duplicates, using inclusion and exclusion criteria, only 22 studies were eligible for inclusion in the review published from January 2020 to May 2022. mHealth interventions accounted for 72.7% (16 of 22 studies) and only 27.3% (6 of 22 studies) were telehealth studies. There were only 3 example studies that integrated digital technologies into healthcare systems and only 3 studies that developed and evaluated the feasibility of mobile apps. Experimental studies accounted 68.8% of mHealth studies and only 33.3% studies of telehealth studies. Key functionalities of the pregnancy apps and telehealth platforms focused on mental and physical wellness, health promotion, patient tracking, health education, and parenting support. Implemented interventions ranged from breastfeeding and selfcare to behavioral health. Facilitators of uptake included perceived benefits, user satisfaction and convenience. Mobile apps and short messaging services were the primary technologies employed in the implemented mHealth interventions. Conclusion Although our Review emphasizes a lack of studies on mHealth interventions and data from pregnant women during the COVID-19 crisis, the review shows that implementation of digital health interventions during emergencies are inevitable given their potential for supporting pregnancy care. There is also a need for more randomized clinical trials and longitudinal studies to better understand the effectiveness and feasibility of implementing such interventions during disease outbreaks and emergencies.
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A randomized controlled trial to evaluate "mami-educ", a mHealth intervention to reduce gestational obesity: Towards personalized prevention. (Preprint)
Article
Full-text available
  • Nov 2022
Background: The World Federation of Obesity warns that the main health problem of the next decade will be childhood obesity. It is known that factors such as gestational obesity produce profound effects on fetal programming and are strong predictors of overweight and obesity in children. Therefore, establishing healthy eating behaviors during pregnancy is the key to the primary prevention of the intergenerational transmission of obesity. Mobile health (mHealth) programs are potentially more effective than face-to-face interventions, especially during a public health emergency such as the COVID-19 outbreak. Objective: This study aims to evaluate the effectiveness of an mHealth intervention to reduce excessive weight gain in pregnant women who attend family health care centers. Methods: The design of the intervention corresponds to a classic randomized clinical trial. The participants are pregnant women in the first trimester of pregnancy who live in urban and semiurban areas. Before starting the intervention, a survey will be applied to identify the barriers and facilitators perceived by pregnant women to adopt healthy eating behaviors. The dietary intake will be estimated in the same way. The intervention will last for 12 weeks and consists of sending messages through a multimedia messaging service with food education, addressing the 3 domains of learning (cognitive, affective, and psychomotor). Descriptive statistics will be used to analyze the demographic, socioeconomic, and obstetric characteristics of the respondents. The analysis strategy follows the intention-to-treat principle. Logistic regression analysis will be used to compare the intervention with routine care on maternal pregnancy outcome and perinatal outcome. Results: The recruitment of study participants began in May 2022 and will end in May 2023. Results include the effectiveness of the intervention in reducing the incidence of excessive gestational weight gain. We also will examine the maternal-fetal outcome as well as the barriers and facilitators that influence the weight gain of pregnant women. Conclusions: Data from this effectiveness trial will determine whether mami-educ successfully reduces rates of excessive weight gain during pregnancy. If successful, the findings of this study will generate knowledge to design and implement personalized prevention strategies for gestational obesity that can be included in routine primary care. Trial registration: ClinicalTrials.gov NCT05114174; https://clinicaltrials.gov/ct2/show/NCT05114174. International registered report identifier (irrid): DERR1-10.2196/44456.
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Quality of life in pregnant women: Association with demographic, socioeconomic, obstetric, and health conditions factors
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  • Nov 2022
Introduction During pregnancy, there are changes that influence a woman’s quality of life. Objective To analyze the quality of life and its association with demographic, socioeconomic, obstetric, and health conditions in pregnant women. Method Quality of life was measured using the WHOQOL-BREF, and to evaluate the association between quality of life domains and exposure variables (demographics, socioeconomic, obstetrics, and health conditions) the inflated beta regression was used. Results In the physical domain, pregnant women had lower scores: with higher parity (OR = .71; 95% CI = [.59, .84]), third pregnancy trimester (OR = .74; 95% CI [.61, .89]), reported common symptom (OR = .80; 95% CI = [.67, .95]), or morbidity (OR = .67; 95% CI [.57, .79]). In the psychological domain, women with planned pregnancy had higher scores (OR = 1.20; 95% CI= [1.04, 1.37]), while those who reported common symptoms (OR = .75; 95% CI = [.63, .89]), or morbidity (OR = .82; 95% CI = [.70, .95]) had the worst scores. Higher income was associated with higher scores in the social relationships domain (OR = 1.22; 95% CI = [1.03, 1.45]). Women in their second pregnancy had lower scores in the environment domain (OR = .84; 95% CI = [.72, .98]), while those with intermediate income had higher scores (OR = 1.23; 95% CI = [1.05, 1.43]). Discussion and conclusion Lower quality of life scores were associated with obstetrics and health conditions variables, while higher scores were related with demographics and socioeconomics variables. The multidimensionality of factors associated with the domains of quality of life during pregnancy is also highlighted, which stresses the importance of intersectoral actions for women in social vulnerability.
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Factors influencing quality of life among syrian refugees pregnant women in Jordan: A cross-sectional study
Article
Full-text available
  • Sep 2022
Background Pregnancy is a critical period of transition incorporating important normal physical, emotional, hormonal, and physiological status changes. These changes might affect the quality of life (QOL) of pregnant woman. This study aimed to examine the levels of quality of life and perceived social support of Syrian refugees’ pregnant women in Al-Zaatari Refugee Camp in Jordan. Methods A cross-sectional survey design was used. A sample of 319 pregnant women was recruited from two maternal health clinics at Al-Zaatari Refugee Camp. Data were collected from June to August 2020 using the Arabic version of World Health Organization Quality of Life (WHOQOL-BREF), the Multidimensional Perceived Social Support (MSPSS) questionnaires, and two sheets were used to assess sociodemographic and obstetric variables. Results The study reveals that Syrian refugees’ pregnant women had good satisfaction with their overall QOL and health status and social support. A significant relationship was found between the socioeconomic index and QOL. Also, age, being in the third trimester, and parity correlated negatively with QOL. In contrast, those who stayed in Jordan as a refugee for a longer period reported better QOL. Conclusion Syrian women in Jordan, in general, have a good QOL and high level of social support. However, women were least satisfied with their physical health domain. Several factors affected QOL including income, employment status, age, number of children, and pregnancy trimester. Social support is an important factor in improving the QOL among Syrian refugees’ pregnant women.
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Quality of Life During Pregnancy from 2011 to 2021: Systematic Review
Article
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  • Dec 2022
Purpose Health-related quality of life (HRQoL) has emerged as a key concern in patient care. It has become one of the major objectives of clinical trials. Our study aims to describe the quality of life (QoL) during uncomplicated pregnancy and to assess its associated factors. Patients and Methods The search of articles was carried out using the online database of PUBMED and Web of Science with a limit of time between 2011 and 2021. Data were retrieved by two independent reviewers. Results 721 publications responding to keywords were identified, of which 73 articles on the topic were selected. The main countries that have published on this subject are Australia (n = 10) and China (n = 7). Twenty-three articles deal with QoL for pathological pregnancies. All the pathologies studied have a negative impact on the HRQoL of pregnant women, and its improvement depends on the type of treatment. Obesity, low back, and pelvic girdle pain, and hyperemesis gravidarum were the frequent pathologies during pregnancy. Socio-demographic characteristics related to improved well-being (favorable economic status, social support). Similarly, better sleep quality and moderate physical exercise were linked to an increased QoL. Physical and psychological factors were associated with a lower QoL. Conclusion The HRQoL refers to patients’ subjective evaluation of physical, mental, and social components of well-being. Optimizing the QoL during pregnancy necessitates a deeper understanding of their issues as well as counseling which provides support wherever needed.
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Effect of Self-monitoring of Blood Pressure on Blood Pressure Control in Pregnant Individuals With Chronic or Gestational Hypertension: The BUMP 2 Randomized Clinical Trial
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Full-text available
  • May 2022
Importance: Inadequate management of elevated blood pressure is a significant contributing factor to maternal deaths. The role of blood pressure self-monitoring in pregnancy in improving clinical outcomes for the pregnant individual and infant is unclear. Objective: To evaluate the effect of blood pressure self-monitoring, compared with usual care alone, on blood pressure control and other related maternal and infant outcomes, in individuals with pregnancy hypertension. Design, setting, and participants: Unblinded, randomized clinical trial that recruited between November 2018 and September 2019 in 15 hospital maternity units in England. Individuals with chronic hypertension (enrolled up to 37 weeks' gestation) or with gestational hypertension (enrolled between 20 and 37 weeks' gestation). Final follow-up was in May 2020. Interventions: Participants were randomized to either blood pressure self-monitoring using a validated monitor and a secure telemonitoring system in addition to usual care (n = 430) or to usual care alone (n = 420). Usual care comprised blood pressure measured by health care professionals at regular antenatal clinics. Main outcomes and measures: The primary maternal outcome was the difference in mean systolic blood pressure recorded by health care professionals between randomization and birth. Results: Among 454 participants with chronic hypertension (mean age, 36 years; mean gestation at entry, 20 weeks) and 396 with gestational hypertension (mean age, 34 years; mean gestation at entry, 33 weeks) who were randomized, primary outcome data were available from 444 (97.8%) and 377 (95.2%), respectively. In the chronic hypertension cohort, there was no statistically significant difference in mean systolic blood pressure for the self-monitoring groups vs the usual care group (133.8 mm Hg vs 133.6 mm Hg, respectively; adjusted mean difference, 0.03 mm Hg [95% CI, -1.73 to 1.79]). In the gestational hypertension cohort, there was also no significant difference in mean systolic blood pressure (137.6 mm Hg compared with 137.2 mm Hg; adjusted mean difference, -0.03 mm Hg [95% CI, -2.29 to 2.24]). There were 8 serious adverse events in the self-monitoring group (4 in each cohort) and 3 in the usual care group (2 in the chronic hypertension cohort and 1 in the gestational hypertension cohort). Conclusions and relevance: Among pregnant individuals with chronic or gestational hypertension, blood pressure self-monitoring with telemonitoring, compared with usual care, did not lead to significantly improved clinic-based blood pressure control. Trial registration: ClinicalTrials.gov Identifier: NCT03334149.
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Systematic review on the cost and cost-effectiveness of mHealth interventions supporting women during pregnancy
Article
Full-text available
  • Mar 2022
Objectives: The increased integration of digital health into maternity care-alongside growing use of, and access to, personal digital technology among pregnant women-warrants an investigation of the cost-effectiveness of mHealth interventions used by women during pregnancy and the methodological quality of the cost-effectiveness studies. Methods: A systematic search was conducted to identify peer-reviewed studies published in the last ten years (2011-2021) reporting on the costs or cost-effectiveness of mHealth interventions used by women during pregnancy. Available data related to program costs, total incremental costs and incremental cost-effectiveness ratios (ICERs) were reported in 2020 United States Dollars. The quality of cost-effectiveness studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Findings: Nine articles reporting on eight studies met the inclusion criteria. Direct intervention costs ranged from 7.04to7.04 to 86 per woman, total program costs ranged from 241,341to241,341 to 331,136 and total incremental costs ranged from -21.16to21.16 to 1.12 million per woman. The following ICERs were reported: 2168perDALYaverted,2168 per DALY averted, 203.44 per woman ceasing smoking, and $3475 per QALY gained. The full economic evaluation studies (n = 4) were moderate to high in quality and all reported the mHealth intervention as cost-effective. Other studies (n = 4) were low to moderate in quality and reported low costs or cost savings associated with the implementation of the mHealth intervention. Conclusions for practice: Preliminary evidence suggests mHealth interventions may be cost-effective and "low-cost" but more evidence is needed to ascertain the cost-effectiveness of mHealth interventions regarding positive maternal and child health outcomes and longer-term health service utilisation.
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SmartMoms Canada: An evaluation of a mobile app intervention to support a healthy pregnancy
Article
  • Dec 2022
  • CONTEMP CLIN TRIALS
Background: There is a lack of cost-effective and readily available access to evidence-based information to manage healthy behaviours for pregnant individuals. Mobile health (mHealth) tools offer a cost-effective, interactive, personalized option that can be delivered anywhere at a time most convenient for the user. This study protocol was primarily developed to i) assess the feasibility of the SmartMoms Canada intervention in supporting participants to achieve gestational weight gain (GWG) guidelines. The secondary objectives are to: ii) assess user experience with the app, measured by adherence to the program via app software metrics and frequency of use; iii) determine the impact of SmartMoms Canada app usage on the adoption of healthful behaviours related to nutrition, physical activity and sleep habits, improvements in health-related quality of life, pregnancy-related complications, and symptoms of depression, and iv) investigate the potential extended effects of the app on postpartum health-related outcomes. Methods: This is a feasibility trial. Pregnant individuals aged 18-40 years with pre-gravid body mass index between 18.5 and 39.9 kg/m2, carrying a singleton fetus, having Wi-Fi access, and at ≤20 weeks' gestation will be recruited. Eligible people will be followed from recruitment until 12 months postpartum. Discussion: SmartMoms Canada is the first bilingual Canadian-centric app designed for pregnant people. This mHealth intervention, with its ability to supply frequent interactions, provides pregnancy- related health knowledge to users, potentially leading to an improvement in pregnancy-related outcomes and behaviours, and, ultimately a reduction in the present economic burden related to in-person interventions. Trial registration: ISRCTN, ISRCTN16254958. Registered 20 December 2019, http://www.isrctn.com/ ISRCTN16254958.
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