FEASIBILITY OF A HEALTHY LIFESTYLE GROUP CLASS + MOBILE HEALTH INTERVENTION FOR OVERWEIGHT/OBESE WOMEN DURING AND AFTER PREGNANCY: A PILOT STUDY

Abstract

Therapeutic Area: ASCVD /CVD Risk Reduction Background: Overweight and obese pregnant women are at greater risk for adverse pregnancy outcomes and excessive gestational weight gain. Mobile health (mhealth) interventions have shown promising results for pregnant women who have multiple time demands. The purpose of this study was to test the feasibility of a healthy lifestyle intervention, with mhealth component, during pregnancy and through 3 months postpartum and to explore its effect on cardiometabolic risk factors. Methods: The Health-texting to Improve Postpartum (HIP) Mom's study took place in the obstetric clinic of a tertiary academic medical center. Pregnant women between 12 to 27 weeks gestation with a pre-pregnancy BMI 25+ kg/m2 were randomized to either usual care or a behavioral lifestyle intervention (5 weekly in-person antepartum group classes to support a healthy lifestyle followed by a text messaging program to reinforce healthy concepts through 3 months postpartum). Weight was measured at predelivery and by 4 months postpartum. Lipids and glucose were collected at 6 weeks and by 4 months postpartum. Results: Fifty-five women were recruited and 29 were randomized to the intervention (52% attended at least 1 or more group classes and 90% received text messages through 3 months postpartum). The mean age was 31.7 years (42% Latino; 22% White; 15% Native Hawaiian/Pacific Islander; 15% Asian; Black 4%) and 34% had Medi-Cal insurance. There was no difference in postpartum weight loss between the intervention and usual care arms at 4 months postpartum (mean 21.6 lbs lost in each group, p>0.9). At 4 months postpartum, women in the intervention group had lower median glucose, higher median HDL, lower median triglycerides, higher median composite self-efficacy scores, and higher median weekly physical activity minutes compared with the usual care group; however, these were not statistically significant. Women who attended 1 or more antenatal group classes were more likely to return for their 4-month study follow-up. Conclusions: Postpartum mhealth messaging appears to be more widely adopted than in-person antenatal group classes in supporting healthy behaviors during and after pregnancy. Healthy lifestyle text messages have the potential to reach busy postpartum women and improve cardiometabolic risk factors regardless of weight loss.