Digital Coaching Reduces Blood Pressure in Early Pregnancy

TOPLINE:

Digital lifestyle coaching through the Smarter Pregnancy program reduces maternal blood pressure (BP) by approximately 2 mmHg during the first trimester of pregnancy. The program enhances lifestyle behaviors through personalized coaching on vegetable and fruit intake, smoking cessation, and alcohol abstinence.

METHODOLOGY:

• Researchers analyzed data from the Rotterdam Periconception Cohort between 2010 and 2019, including 132 pregnant women who used Smarter Pregnancy for 6-24 weeks in the intervention group and 1091 pregnant women in the control group.
• Participants’ outcomes included changes in systolic, diastolic, and mean arterial BPs between baseline and first trimester measurements, with median gestational age of 7 weeks at inclusion.
• Analysis tracked lifestyle behaviors in the intervention group at 12 and 24 weeks using risk scores for vegetables, fruits, smoking, and alcohol consumption.
• Multivariable analysis adjusted for baseline BP measurements, age, gestational age, geographic origin, parity, and conception mode to evaluate program effectiveness.

TAKEAWAY:

• The intervention group demonstrated significant reductions in systolic (β, −2.34 mmHg; 95% CI, −4.67 to −0.01; P = .049), diastolic (β, −2.00 mmHg; 95% CI, −3.57 to −0.45; P = .012), and mean arterial BP (β, −2.22 mmHg; 95% CI, −3.81 to −0.52; P = .011) compared with controls.
• Among women who underwent assisted reproductive technology (ART), significant reductions were observed in diastolic (β, −2.38 mmHg; 95% CI, −4.20 to −0.56) and mean arterial BP (β, −2.63 mmHg; 95% CI, −4.61 to −0.56).
• Program usage was associated with decreased lifestyle risk scores at 12 weeks (β, −0.84; 95% CI, −1.19 to −0.49) and 24 weeks (β, −1.07; 95% CI, −1.44 to −0.69), indicating improved lifestyle behaviors.
• Lifestyle risk scores significantly decreased in both ART and natural pregnancy subgroups after program completion.

IN PRACTICE:

“The findings suggest that Smarter Pregnancy can be used to coach women on healthy lifestyle behaviors commencing from the preconception period onwards to improve BP outcomes. Of note, although implementing the program during [the] first trimester seems easier, initiating lifestyle coaching as early as preconceptional period can act as preventive measure against adverse health outcomes,” wrote the authors of the study.

SOURCE:

The study was led by Batoul Hojeij, PhD, Erasmus University Medical Center in Rotterdam, the Netherlands. It was published online in the American Journal of Preventive Medicine.

LIMITATIONS:

According to the authors, participants in the intervention group might have had healthier lifestyles due to their motivation to use a digital coaching program. The sample size of naturally conceived pregnancies in the intervention group was small (n = 41), reducing statistical power for subgroup analysis. The high percentage of missing data for baseline BP measurements (64%) could have affected statistical power and led to potential bias, though multiple imputations were used to address this limitation.

DISCLOSURES:

This study was supported by the European Union’s Horizon 2020 research and innovation program (DohART-NET) and the Department of Obstetrics and Gynaecology of the Erasmus MC. Kevin D Sinclair, PhD, DSc, received funding from the Biotechnology and Biological Sciences Research Council.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.