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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (3): 465-472. doi: 10.19723/j.issn.1671-167X.2025.03.009

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A randomized controlled trial of weight management based on mobile health techno-logy among overweight or obese pregnant women

Ping LI1, Haixue WANG1, Xiao GAO2, Yajing HAN2, Hui WANG1, Haijun WANG1,*(), Yingying MU2,*()   

  1. 1. Department of Maternal and Child Health, Peking University School of Public Health / Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health / National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
    2. Weifang Maternal and Child Health Center, Weifang 261011, Shandong, China
  • Received:2025-02-08 Online:2025-06-18 Published:2025-06-13
  • Contact: Haijun WANG, Yingying MU
  • Supported by:
    Peking University Health Science Center-Weifang Maternal and Child Health Joint Research Center(PKUWF-Y09)

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Abstract:

Objective: To evaluate the effect of lifestyle interventions based on mobile health technology on gestational weight gain among overweight or obese pregnant women, to explore the influencing factors of the intervention effect, and to provide scientific evidence for weight management during pregnancy. Methods: The randomized controlled trial (RCT) design was used. From April 2024 to August 2024, 200 singleton overweight or obese pregnant women aged 18-40 years in early pregnancy were recruited and stratified block-randomized according to body mass index (BMI) categories, age, and parity. The control group received routine prenatal care, while the intervention group received lifestyle interventions based on mobile health technology, which included biweekly face-to-face or telephone sessions; weekly recording of dietary behavior goals with personalized feedback on WeChat public account; 6 000 steps per day and 150 minutes of brisk walking per week; and weekly weight recording with personalized feedback. Based on the intention-to-treat principle, generalized linear mixed models were used to analyze the effects on weight gain and weight gain rate up to 24-28 gestational weeks, gestational diabetes mellitus (GDM), and dietary and physical activity behaviors. Additionally, subgroup analysis and interaction analysis were conducted to explore whether intervention effects on weight gain varied by different maternal characteristics. Results: The mean age of the women in the intervention and control groups was (30.49± 3.99) years and (29.83±3.95) years, respectively, with gestational weeks at enrollment being (11.35±1.61) weeks and (11.26±1.52) weeks. No statistically significant differences were observed in the baseline characteristics between the two groups (P>0.05). In the study, 10 and 12 participants were lost to the follow-up in the intervention and control groups, respectively, with 178 women completing the midterm follow-up. At the midterm follow-up (24-28 weeks), the weight gain in the intervention and control groups was (5.00±3.72) kg and (6.57±4.28) kg, respectively. After adjusting for age, parity, gravidity, region, pre-pregnancy BMI categories, and socioeconomic status, the between-group difference was -1.63 kg (95%CI: -2.80 to -0.46; P=0.007). The adjusted between-group difference in weight gain rate was -0.07 kg/week (95%CI: -0.11 to -0.02; P=0.005). Compared with the control group, the intervention group had lower fasting blood glucose at the oral glucose tolerance test (OGTT) by 0.19 mmol/L (95%CI: 0.04 to 0.33; P=0.013). No significant difference was observed in GDM incidence between the two groups. Among different subgroups based on characteristics, such as age, region, socioeconomic status, and parity, there was no statistically significant dif-ference in the effect on weight gain. Conclusion: The lifestyle interventions based on mobile health technology effectively controlled weight gain up to 24-28 gestational weeks among overweight or obese women and improved fasting blood glucose level. This has significant public health implications for improving the health of overweight or obese pregnant women in China.

Key words: Gestational weight gain, Overweight, Obesity, Randomized controlled trial, Mobile health

CLC Number: 

  • R715.3

Table 1

Baseline characteristics of the participants"

Variable All (n=200) Control group (n=100) Intervention group (n=100) P value
Age/years 30.16±3.97 29.83±3.95 30.49±3.99 0.244
Gestational age/weeks 11.31±1.56 11.26±1.52 11.35±1.61 0.504
Pre-pregnancy BMI/(kg/m2) 27.88±3.25 27.68±3.03 28.08±3.45 0.596
Overweight 122 (61.0%) 61 (61.0%) 61 (61.0%) >0.999
Associate degree or above 169 (84.5%) 86 (86.0%) 83 (83.0%) 0.558
Employed 152 (76.0%) 75 (75.0%) 77 (77.0%) 0.741
Green score 64.89±8.63 64.83±8.53 64.95±8.76 0.824
Gravidity 0.752
  1 93 (46.5%) 49 (49.0%) 44 (44.0%)
  2 70 (35.0%) 34 (34.0%) 36 (36.0%)
  ≥3 37 (18.5%) 17 (17.0%) 20 (20.0%)
Primiparous 133 (66.5%) 69 (69.0%) 64 (64.0%) 0.454
Natural conception 188 (95.4%) 95 (96.0%) 93 (94.9%) 0.747
PCOS history 25 (12.5%) 10 (10.0%) 15 (15.0%) 0.285
Diabetes family history 46 (23.0%) 24 (24.0%) 22 (22.0%) 0.737
GDM history 3 (1.5%) 2 (2.0%) 1 (1.0%) >0.999
Nausea 126 (63.0%) 63 (63.0%) 63 (63.0%) >0.999
MET-min/week 622.12±716.18 645.17±840.43 599.07±568.87 0.167
Daily steps 3 882±2 685 3 680±2 277 4 081±3 030 0.486
Energy intake/(kcal/d) 1 935±585 1 887±574 1 982±595 0.203
Protein intake/(g/d) 74.53±24.41 73.00±24.42 76.05±24.43 0.282
Carbohydrate intake/(g/d) 303.63±100.55 297.07±98.06 310.19±103.05 0.323
Fat intake/(g/d) 48.48±19.23 46.73±19.74 50.24±18.63 0.143
DBI_P 14.88±8.83 14.12±8.65 15.64±8.98 0.214

Table 2

Weight gain in the intervention and control groups"

Variables Intervention group (n=90) Control group (n=88) MD/RR (95%CI) P value
GWG/kg 5.00±3.72 6.57±4.28 -1.63 (-2.80, -0.46) 0.007
GWG rate/(kg/week) 0.19±0.14 0.25±0.17 -0.07 (-0.11, -0.02) 0.005
T1-T2 GWG/kg 4.53±2.79 5.80±3.94 -1.33 (-2.33, -0.33) 0.010
T1-T2 GWG rate/(kg/week) 0.31±0.19 0.40±0.27 -0.09 (-0.16, -0.03) 0.008
28-week GWG/kg 5.57±3.78 7.83±4.40 -2.23 (-3.40, -1.06) < 0.001
EGWG 41 (46.1%) 50 (58.8%) 0.51 (0.27, 0.96) 0.036
IGWG 25 (28.1%) 16 (18.8%) 1.94 (0.91, 4.09) 0.084
AGWG 23 (25.8%) 19 (22.4%) 1.32 (0.66, 2.63) 0.439

Table 3

Diet and physical activity in the intervention and control groups"

Variables Intervention group (n=90) Control group (n=88) MD (95%CI) P value
Baseline Midterm Baseline Midterm
MET-min/week 599.1±568.9 1 070.8±831.0 645.2±840.4 681.6±551.6 412.70 (211.27, 614.13) < 0.001
Daily steps 4 081±3 030 5 213±2 382 3 680±2 277 3 795±2 386 1 189 (547, 1 830) < 0.001
Energy intake/(kcal/d) 1 982±595 1 804±537 1 887±574 2 032±736 -250.2 (-441.9, -58.5) 0.011
Protein intake/(g/d) 76.05±24.43 77.83±21.75 73.00±24.42 82.65±28.15 -6.03 (-13.41, 1.34) 0.111
Carbohydrate intake/(g/d) 310.2±103.0 265.6±103.6 297.1±98.1 306.0±124.1 -43.41 (-77.42, -9.39) 0.013
Fat intake/(g/d) 50.24±18.63 51.19±14.50 46.73±19.74 55.69±23.28 -5.26 (-10.99, 0.48) 0.074
DBI_P 15.64±8.98 13.60±9.17 14.12±8.65 15.33±9.87 -2.32 (-5.04, 0.40) 0.097

Table 4

Effects on weight gain (kg) in pregnant women with different characteristics"

Variables Intervention group (n=90) Control group (n=88) MD (95%CI) P value P value for interaction
Age 0.191
  ≥30 years 5.53±3.29 6.25±3.44 -0.90 (-2.30, 0.50) 0.210
   < 30 years 4.32±4.15 6.83±4.90 -2.30 (-4.20, -0.39) 0.021
BMI categories 0.982
  Overweight 5.71±3.34 7.36±4.34 -1.40 (-2.90, 0.10) 0.070
  Obese 3.84±4.05 5.31±3.93 -1.49 (-3.45, 0.47) 0.141
Region 0.493
  Weifang, Shandong 5.21±3.67 7.34±4.70 -1.76 (-3.48, -0.04) 0.048
  Tongzhou, Beijing 4.78±3.80 5.61±3.52 -1.30 (-2.92, 0.31) 0.117
Parity 0.882
  Primiparous 4.72±3.95 6.52±4.80 -1.63 (-3.2, -0.07) 0.043
  Multiparous 5.48±3.30 6.68±2.57 -1.39 (-3.07, 0.29) 0.111
Socioeconomic status 0.834
  Higher 5.38±2.97 7.01±4.64 -1.91 (-3.51, -0.32) 0.021
  Lower 4.57±4.41 6.13±3.89 -1.62 (-3.42, 0.17) 0.080
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