Bethany Helm
Medway Maritime Hospital
Title: The effectiveness of eHealth weight-management interventions for pregnant and postpartum women: a systematic review and meta-analysis.
Biography
Biography: Bethany Helm
Abstract
Aims/Objectives: To determine the efficacy of eHealth weight management interventions on promoting postpartum weight loss and minimising excessive GWG in pregnant women.
Background: The prevalence of excessive gestational weight gain (GWG) and postpartum weight retention are increasing globally with associated risks to mother and child. Effective weight-management interventions for pregnant and postpartum women are required. eHealth interventions can deliver weight loss advice remotely, attain wide-reach and provide personalised feedback and goals; thus, easy implementation in this cohort is expected.
Materials and methods: A systematic review and meta-analysis was conducted following the PRISMA guidance. A search was conducted using MEDLINE, EMBASE, Psych Info, The Cochrane Library, PubMed, and the JMIR, up until January 2018. We searched for RCTs of eHealth weight management interventions in pregnant and postpartum women. Search terms included pregnancy, postpartum, eHealth, weight, weight loss and RCT. Study selection was conducted independently against the inclusion criteria. The primary outcome was weight-change. Secondary outcomes included physical activity and BMI. The Cochrane Risk of Bias Tool was used to assess methodological quality of trials.
Results, Summary/Conclusions: Of the 2233 identified studies, 16 met inclusion criteria and were summarised in a narrative review. 14 studies were included in a statistical meta-analysis; 6 compared eHealth interventions to usual care in postpartum women and 8 for pregnant women. eHealth interventions significantly improved postpartum weight loss (kg)(mean difference (MD) -2.61 [-3.66, -1.57] P< .0.001, I2=58%), but were unable to limit GWG (kg) in pregnant women (MD -0.15 [-1.44, 1.13] P= .81, I2=65%). Impact of these results is unclear due to the inclusion of pilot studies, lack of long-term trials and a substantial risk of bias and heterogeneity. All studies were conducted in high-income countries, implying that eHealth requires greater focus for implementation into low-income countries. eHealth interventions require further development and more rigorous trialling to support their use for weight-management in pregnant and postpartum women.