• Am J Prev Med · Nov 2024

    Smarter Pregnancy coaching and maternal blood pressure.

    • Batoul Hojeij, Sam Schoenmakers, Isa Van Mullem, Sten P Willemsen, Andras Dinnyes, Kevin D Sinclair, Melek Rousian, and Régine Pm Steegers-Theunissen.
    • Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam 3015GD, The Netherlands.
    • Am J Prev Med. 2024 Nov 29.

    IntroductionMaternal lifestyle behaviours can affect blood pressure with consequences for maternal and offspring health. The aim of this study was to investigate the effectiveness of the Smarter Pregnancy digital lifestyle coaching program on maternal blood pressure during the first trimester.MethodsThe study was conducted on data of the Rotterdam Periconception Cohort from 2010 to 2019 (analysis completed in 2024). The intervention group included 132 pregnant women using Smarter Pregnancy for 6 to 24 weeks, within 30 months before study entry. The control group included 1,091 pregnant women that did not use Smarter Pregnancy. Outcomes included changes in systolic, diastolic and mean arterial blood pressures between baseline and first trimester. Lifestyle behaviours were tracked in the intervention group at 12 and 24 weeks of the program, using lifestyle risk score for vegetables, fruits, smoking and alcohol.ResultsUsing multivariable analysis, the intervention group showed reductions in systolic (βadj -2.34 mmHg, 95%CI -4.67 to -0.01), diastolic (βadj -2.00 mmHg, 95%CI -3.57 to -0.45) and mean arterial blood pressures (βadj -2.22 mmHg, 95%CI -3.81 to -0.52) compared with the control group. When stratifying for conception mode, reductions were observed in diastolic (βadj -2.38, 95%CI -4.20 to -0.56) and mean arterial blood pressures (βadj -2.63, 95%CI -4.61 to -0.56) only in women who underwent assisted reproduction (n=91). Smarter Pregnancy use was associated with a reduction in lifestyle risk score, indicating improved lifestyle behaviours, after 12 (β -0.84, 95%CI -1.19 to -0.49) and 24 weeks (β -1.07, 95%CI -1.44 to -0.69). The lifestyle risk score was also significantly reduced in ART and natural pregnancy subgroups.ConclusionsThe use of Smarter Pregnancy is associated with consistent but small reductions in maternal blood pressure during the first trimester, supporting further implementation in health care.Copyright © 2024. Published by Elsevier Inc.

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