A SYSTEMATIC review of 42 randomised trials involving 148,866 participants has demonstrated that digital health interventions (DHIs) significantly reduce excessive gestational weight gain (GWG) and lower risks of miscarriage and preterm birth, though they may inadvertently increase small-for-gestational-age (SGA) infants in high-risk pregnancies.
Gestational weight gain is a critical determinant of maternal and neonatal health, yet many women struggle to meet recommended guidelines, heightening risks of complications such as preeclampsia and cesarean delivery. Digital health tools—including mobile apps, telehealth platforms, and wearable devices—have emerged as scalable solutions for supporting pregnancy management. This meta-analysis evaluates their effectiveness in improving clinical outcomes across diverse populations, offering insights into their potential benefits and limitations.
The review analysed 42 randomised controlled trials (RCTs) spanning PubMed, Embase, and Cochrane databases up to August 2024. Interventions included apps for diet/exercise tracking, remote monitoring, and personalised feedback. Compared to routine care, DHIs reduced GWG by a standardised mean difference of −0.19 (95% CI: −0.25 to −0.13; p<0.001), with overweight/obese participants showing greater reductions (−0.35 kg, 95% CI: −0.45 to −0.24; p<0.001). The odds of excessive GWG fell by 21% (OR 0.79, 95% CI: 0.69–0.91; p=0.001), while adherence to Institute of Medicine guidelines improved by 33% (OR 1.33, 95% CI: 1.10–1.64; p=0.003). DHIs also lowered miscarriage risk by 34% (OR 0.66, 95% CI: 0.46–0.95; p=0.03) and preterm birth by 20% (OR 0.80, 95% CI: 0.75–0.86; p<0.001). Neonatal complications declined by 7% (OR 0.93, 95% CI: 0.87–0.99; p=0.02). However, SGA incidence rose in high-risk subgroups, particularly among women with obesity or gestational diabetes, likely due to overly restrictive interventions.
These findings highlight DHIs’ potential to enhance maternal and neonatal outcomes but underscore the need for tailored approaches to avoid unintended harms like SGA. For clinical practice, integrating DHIs into prenatal care could optimise GWG management, especially for overweight/obese individuals. Future research should refine intervention designs to balance weight control with fetal growth needs and explore socioeconomic barriers to DHI access. Policymakers must prioritise equitable digital health strategies to ensure benefits extend to underserved populations.
Katrina Thornber, EMJ
Reference
Wang J et al. Association of digital health interventions with maternal and neonatal outcomes: systematic review and meta-analysis. Journal of Medical Internet Research. 2025;27:e66580.
