Obesity during pregnancy has been steadily increasing worldwide. In the United States, over 60% of pregnant individuals enter pregnancy overweight or obese, and more than half go on to exceed recommended gestational weight gain guidelines. This growing pattern is a concern for health care professionals, as obesity during pregnancy is linked to a higher risk of several health complications for the mother.
A recent study published in JAMA Network Open has found that a mobile health app that adapts to individual users can make it easier for pregnant mothers to reach their recommended weight goals.
The Lifestyle, Eating, Activity in Pregnancy (LEAP) study brought together 58 clinicians and 1,265 pregnant patients with overweight or obesity in a large real-world clinical trial. It tested whether a mobile health (mHealth) intervention could help participants avoid gaining more weight than recommended during pregnancy.
The app provided 13 weekly lessons focused on healthy eating and physical activity, delivered through chats and, when needed, phone support from a lifestyle coach.
By the end of the study, women using the mHealth approach had gained less weight during pregnancy than those receiving standard care, with an average difference of about 0.87 kilograms (roughly 2 pounds).
A touch away from weight management support
Accelerated gestational weight gain can have lasting effects on both mother and baby. It increases the risk of conditions like high blood pressure, preeclampsia, and gestational diabetes. These can lead to further complications, including kidney and liver problems, having a larger-than-average baby, and a greater chance of needing a cesarean birth. Sleep apnea is also more common, which can contribute to ongoing fatigue and strain on the heart and lungs.
Studies show that one-on-one counseling with doctors can help improve habits and manage weight gain during pregnancy. However, this kind of support takes significant time and resources, making it difficult to offer during routine checkups.
To overcome these issues, researchers of this study began looking for a simpler, more scalable way to help pregnant women with overweight or obesity avoid gaining weight faster than recommended.
In the LEAP study, researchers used a cluster-randomized design, in which they divided the 58 participating doctors rather than dividing the patients into two groups. All the pregnant patients under each doctor then followed the same program.
Patients in the standard care group received a newsletter at their first visit that explained the Institute of Medicine guidelines on weight gain and included tips for healthy eating. After that, they continued with routine prenatal visits, during which their doctors tracked their weight.
In contrast, the LEAP intervention group received a set of digital tools, including a smartphone app, a wireless scale, and a fitness tracker, along with weekly coaching.
The support was designed to adapt in real time: if a patient began gaining weight too quickly, the program stepped up to personalized messages from a health coach, and, if needed, to one-on-one phone calls. Doctors in this group were also trained to have more effective conversations with patients about weight.
People in the LEAP program gained less weight during pregnancy than those receiving standard care. More of them stayed within the recommended healthy range, and fewer saw their weight climb too quickly. There was also a benefit for babies born to mothers in the LEAP program, as they were less likely to be classified as large for gestational age, which can be a health risk for newborns.
The researchers note that even small improvements in pregnancy weight gain among high-risk patients could have meaningful benefits when applied across large populations.
This technology-based approach has the potential to deliver accessible, evidence-based support at scale, helping pregnant patients manage their health and reduce complications for both mother and baby.