A Pedometer-Guided Physical Activity Intervention for Obese Pregnant Women (the Fit MUM Study): Randomized Feasibility Study

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Obesity in pregnancy is a growing problem worldwide, with excessive gestational weight gain (GWG) occurring in the majority of pregnancies. This significantly increases risks to mother and child. A major contributor to both pre-pregnancy obesity and excessive GWG is physical inactivity, however past interventions targeting maternal weight gain and activity levels during the antenatal period have been ineffective in women who are already overweight. Pedometer-guided activity may offer a novel solution to increasing activity levels in this population. Objective: Our aim in this initial feasibility randomized controlled trial was to test a pedometer-based intervention to increase activity and reduce excessive GWG in thirty pregnant women. Methods: Thirty pregnant women with obesity were supplied with a Fitbit Zip® pedometer, and randomized to one of three groups; Control: pedometer-only; App: pedometer-synched to patients’ personal smartphones, with self-monitoring of activity; App-coach: addition of a health-coach delivered behavioral change program. Feasibility outcomes included participant compliance with wearing pedometers, data synching, and data integrity; activity outcomes (step counts, active minutes) were analysed using linear mixed models and generalised estimating equations. Results: Twenty-seven participants completed the study; mean BMI in all groups was ≥ 35 kg/m2. Recruitment and retention rate were feasible, as was activity data synching to participants’ smartphones, although mean (SD) percentage of missing data days were 23.4% (20.6%), 39.5% (32.4%), and 21.1% (16.0%) in control, App group and App-coach group patients respectively. Estimated mean baseline activity levels were 14.5 active minutes/day and 5455 steps/day, with no significant differences found in activity levels between groups. Conclusions: Activity data synching with a personal smartphone is feasible in a cohort of pregnant women with obesity. A future definitive study seeking to reduce GWG and improve activity in this population must focus on improving compliance with activity data recording, and behavioural interventions delivered. Clinical Trial: Australian and New Zealand Clinical Trials Registry ACTRN12617000038392.