Key result
The Pregnancy Butler eHealth intervention did not significantly reduce the overall incidence of excessive gestational weight gain compared to standard care (34% vs 36%, p=0.879).
Why the study?
Excessive gestational weight gain is a major metabolic risk, but effective tools are lacking to assist healthcare providers in efficiently and continuously implementing interventions and monitoring from early pregnancy.
Does the Pregnancy Butler eHealth solution reduce excessive gestational weight gain in pregnant women?
RCT (n=362)
Open-label
Randomly assigned
No
Does the Pregnancy Butler eHealth solution reduce excessive gestational weight gain in pregnant women?
Absolute Event Rate: 34% vs 36%
p-value: p=0.879
An eHealth intervention for gestational weight gain management did not significantly reduce excessive weight gain in the overall cohort but showed potential benefit in overweight and obese pregnant women.
No support for implementing Pregnancy Butler; challenges efficacy of standalone eHealth interventions for gestational weight management.
Background Excessive gestational weight gain (eGWG) is one of the major metabolic risks for fetal macrosomia, maternal overweight, gestational diabetes mellitus (GDM), and gestational hypertension during pregnancy, which also increase the risk of postpartum weight retention. Gestational weight gain (GWG) management is rising to be attractive during prenatal care, however, there is still lack of effective tools to assist health care providers (HCPs) to efficiently and continuously implement intervention and monitor from the early phase of pregnancy. The current study tested a prototype eHealth solution aiming to assist clinicians to prevent eGWG and associated gestational metabolic complications. Methods A randomized controlled study was conducted in a private hospital in Beijing, China, with control group (N = 181) and intervention group (N = 181) recruited in rolling fashion. The control group received standard prenatal care, while the intervention group was additionally provided with the integrated prenatal care eHealth solution, Pregnancy Butler, which includes mobile application-enabled on-line service and off-line consultation session. The prevalence of eGWG, associated metabolic health parameters, and final pregnancy outcome were evaluated. Results Although mostly with normal pre-pregnancy BMI, the incidence for eGWG was high among the study subjects, at 35%. Engagement with the eHealth platform of the intervention group was stable after initial phase, but less than desired. Pregnancy Butler intervention showed significant benefit (p-value = 0.0496) in preventing eGWG among obese and overweight subjects. And highly engaged active users in the intervention group had more favorable GWG classification (p-value = 0.022). The time-course data collected indicated that the metabolic risks were largely set early in the first trimester already. Conclusions Our preliminary results indicated that the effectiveness of the eHealth intervention considerably depend on each participant’s engagement level and baseline risk factors. In order to achieve more consistent and impactful outcome improvement, focusing on those with pre-existing metabolic risks, increasing engagement and adherence level, and emphasizing intervention from the first trimester could be promising directions. Trial registration: This study was retrospectively registered as “Pregnancy Butler for gestational weight gain management” (ChiCTR1800014647) under the China Clinical Trial Registry in 2018-Jan-26. http://www.chictr.org.cn/showprojen.aspx?proj=24171
No takes yet. Share an insight, caveat, or question.
Wang et al. (2020) conducted an RCT in Excessive gestational weight gain (n=362). Pregnancy Butler eHealth solution vs. Standard prenatal care with paper weight tracking was evaluated on Excessive gestational weight gain (eGWG) (p=0.879). The Pregnancy Butler eHealth intervention did not significantly reduce the overall incidence of excessive gestational weight gain compared to standard care (34% vs 36%, p=0.879).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: