Efficacy of Mobile Application Delivered Lifestyle Interventions in Managing Gestational Weight Gain: A Systematic Review and Meta-Analysis with Meta-Regression

Introduction: Managing gestational weight gain (GWG) is crucial for the health of mothers and their children. Mobile applications (apps) specifically designed for pregnancy are emerging as modalities to deliver accessible lifestyle intervention at a low-cost. However, current studies are varied in results and suffer from heterogeneity. Thus, we conducted this systematic review and meta-analysis to summarize the efficacy of mobile apps in managing GWG and investigate variables that may contribute to heterogeneity. Methodology: Seven databases were systematically searched up to 9 November, 2024. Only randomized controlled trials (RCTs) were included. Outcomes were excessive GWG and inadequate GWG according to the 2009 Institute of Medicine (IOM) guideline. Quality appraisal was performed using the Cochrane Risk of Bias 2 (RoB 2) tool. Random-effect model meta-analysis was conducted using odds ratio (OR) as the summary measure alongside their 95% confidence intervals (CI). Results and Discussion: Fifteen RCTs were included. Mobile apps led to a significant overall decrease in excessive GWG (OR: 0.71; 95% CI: 0.54 to 0.95; p-value: 0.02; I2: 60%). Subgroup analysis showed that social media apps, self-monitoring functionalities, and overweight/obese patients are associated with a significant reduction in excessive GWG. However, there was significant evidence of small-study bias in the analysis. Moreover, mobile apps also significantly increased inadequate GWG (OR: 1.51; 95% CI: 1.04 to 2.21; I2: 0%). Meta-regression did not reveal any significant finding. Conclusion: In conclusion, mobile app interventions are shown to be effective in preventing excessive GWG, particularly social media apps and those with self-monitoring functionalities. However, the reduction in excessive GWG may only be seen in overweight and obese patients and more studies are needed to ascertain this finding. Lastly, mobile apps are associated with an increased risk of inadequate GWG and strategies to combat inadequate GWG are needed.