Summary: In 200 overweight or obese pregnant women in China, a mobile health lifestyle intervention (app-supported diet, activity and weight feedback) was compared with routine prenatal care. By 24 to 28 gestational weeks the intervention reduced gestational weight gain by an adjusted 1.63 kg (95% CI -2.80 to -0.46; p=0.007) and lowered fasting glucose at OGTT by 0.19 mmol/L (95% CI 0.04 to 0.33; p=0.013), but it did not significantly reduce gestational diabetes incidence.
PICO Summary
| Element | Detail |
|---|---|
| Population | 200 singleton overweight or obese pregnant women, aged 18 to 40 years, enrolled in early pregnancy; single-centre, stratified block-randomised trial in China; intention-to-treat analysis, 178 completed the 24 to 28 week midterm follow-up. |
| Intervention | Mobile health lifestyle programme (n=100): biweekly in-person or telephone sessions, weekly WeChat dietary-goal recording with personalised feedback, a target of 6000 steps per day plus 150 minutes of brisk walking per week, and weekly weight recording with feedback. |
| Comparison | Routine prenatal care without the mobile health programme (n=100). |
| Outcome | Adjusted between-group difference in weight gain to 24 to 28 weeks -1.63 kg (95% CI -2.80 to -0.46; p=0.007); weight-gain rate -0.07 kg/week (95% CI -0.11 to -0.02; p=0.005); fasting glucose at OGTT lower by 0.19 mmol/L (95% CI 0.04 to 0.33; p=0.013). No significant between-group difference in gestational diabetes incidence, and no significant subgroup interaction by age, region, socioeconomic status or parity. ARR/NNT not reported. |
mHealth weight management in pregnancy
RCT · overweight/obese pregnancy · 24-28 wks
App-supported lifestyle coaching cut gestational weight gain by about 1.6 kg and modestly lowered fasting glucose, but did not significantly reduce gestational diabetes incidence.
Expert Commentary
This single-centre randomised trial offers cautiously encouraging support for app-supported lifestyle coaching in pregnancy, with a modest and statistically significant reduction in gestational weight gain of around 1.6 kg and a small improvement in fasting glucose by midterm follow-up. The effect sizes are plausible and were derived under intention-to-treat analysis with adjustment for relevant confounders, which strengthens confidence in the direction of benefit. Two limitations temper enthusiasm. The behavioural nature of the intervention means it could not be blinded, so the open-label design leaves outcomes such as self-reported diet and activity vulnerable to performance and reporting bias; the more objective weight and glucose measures are reassuring but were assessed only to 24 to 28 weeks, leaving birth outcomes unaddressed. Importantly, gestational diabetes incidence was not significantly reduced, so the glucose signal should be read as exploratory rather than as proven prevention. Can I use this with my patients? Tentatively yes, as a low-risk adjunct for motivated overweight or obese pregnant women who are comfortable with app-based tracking, but not as a replacement for standard antenatal care or as a means of preventing gestational diabetes. Larger multicentre trials reporting delivery and neonatal endpoints are needed before firmer recommendations can be made.
References
Li P, Wang H, Gao X, Han Y, Wang H, Wang H, Mu Y. A randomized controlled trial of weight management based on mobile health technology among overweight or obese pregnant women. Beijing Da Xue Xue Bao Yi Xue Ban. 2025;57(3):465-472. doi:10.19723/j.issn.1671-167X.2025.03.009