Real-Time Assessment of Symptoms for Postpartum Care via a Smartphone Application: Pilot Evaluation [ID: 1376090

Abstract

INTRODUCTION: Leading causes of morbidity and mortality in women occur in the postpartum period and include postpartum mood disorders, substance use disorders, hypertensive disorders, and infection. This study pilots Gator MOMitor, a smartphone application utilizing ecological momentary assessment (EMA) technology, which allows clinicians to monitor symptoms in at-risk postpartum women in real time. METHODS: Gator MOMitor used a HIPAA-compliant EMA platform to send tailored assessments through the app to postpartum women with health risks in the initial 6 weeks postpartum, including mood disorder (n=401), cesarean infections (n=162), preeclampsia (n=154), and diabetes (n=9). Nonresponsiveness or critical responses submitted by patients in the app generated a trigger based on assessment algorithms, prompting a call from a nurse for follow-up and/or referral. RESULTS: A total of 401 participants were enrolled. 60% identified as White race, 22% Black race, and 14% identified as Hispanic ethnicity. Half (52%) were enrolled in Medicaid, and most (84%) had a term delivery. A total of 3,778 assessments were completed in the app: 1,599 for postpartum mood, 620 for cesarean incision, 1,536 for hypertension, and 24 for diabetes. There were 52, 103, and 39 positive screenings, respectively, in mood assessments (≥12 on the Edinburgh Postnatal Depression Scale), hypertension (BP≥140/90), and cesarean incision concerns, and zero positive screens in the diabetes group. The assessment-based triggers from positive screens resulted in 209 nurse follow-ups, 35 face-to-face visits, and 8 hospital admissions. CONCLUSION: GatorMOMitor may be an effective tool for extended assessment and monitoring of postpartum women that could reduce maternal mortality and morbidity.