Abstract
BackgroundPerinatal morbidity and mortality remain significant public health issues globally, with enduring impact on the health and well-being of women and their families. Pregnant women who adopt, practice and maintain healthy behaviours can potentially improve the health of themselves and their babies. Mobile applications are an increasingly popular mode of accessing, storing and sharing health information among pregnant women. The main objective of this review is to evaluate the effects of mobile application interventions during pregnancy on maternal behaviour and associated maternal and infant outcomes.MethodsThis review will include randomised and non-randomised studies which tested use of mobile applications designed to improve either maternal knowledge or behaviours to address known risk factors associated with adverse perinatal health outcomes. This review will include studies which included pregnant women and/or women during birth. The search strategy will utilise a combination of keywords and MeSH terms. Literature databases such as PubMed, Embase, The Cochrane Library, CINAHL and WHO Global Health Library will be searched. Two reviewers will independently screen retrieved citations to determine if they meet inclusion criteria. Studies will be selected that provide information about interventions commenced in early pregnancy, late pregnancy or labour.Comparisons to be made include mobile applications versus interventions relying on paper-based or text-messaging-based communication; interpersonal communication such as face-to-face or telephone conversation; and no intervention or standard care. Quality assessment of included randomised studies will utilise established guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. Quality assessment of non-randomised studies will be based on the Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-I) assessment tool. Quality of the evidence will be evaluated using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Separate comparisons and analyses for primary and secondary outcomes will be performed. Results of the review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.DiscussionThis systematic review will identify and synthesize evidence about the effect of interventions delivered through mobile applications on influencing maternal behaviour and improving perinatal health outcomes.Systematic review registrationPROSPERO CRD42016037344.
Highlights
Perinatal morbidity and mortality remain significant public health issues globally, with enduring impact on the health and well-being of women and their families
Aim This review aims to assess the effects of mobile application interventions during pregnancy on influencing healthy maternal behaviour and improving perinatal health outcomes, compared with interventions using other communication modalities or with standard care
This systematic review is the first to assess the effects of mobile application interventions during pregnancy on influencing healthy maternal behaviour and improving perinatal outcomes
Summary
Perinatal morbidity and mortality remain significant public health issues globally, with enduring impact on the health and well-being of women and their families. Some maternal risk factors for adverse perinatal health outcomes, such as obesity, smoking, substance use, hypertension, diabetes, adequate nutrition [1,2,3] and maternal perception of decreased fetal movement [4], may be modifiable through changes in maternal behaviour. These risk factors have an association with increased rates of stillbirth, pre-term birth, low birthweight and small for gestational age babies, and emergency caesarean section [5]. Women are increasingly turning to digital sources of information during pregnancy [6], and may prefer these modalities over traditional, paper-based formats [7]
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