Continuous 7-Month Internet of Things-Based Monitoring of Health Parameters of Pregnant and Postpartum Women: Prospective Observational Feasibility Study

Johanna Saarikko; Hannakaisa Niela-Vilen; Eeva Ekholm; Lotta Hamari; Iman Azimi; Pasi Liljeberg; Amir M Rahmani; Eliisa Löyttyniemi; Anna Axelin

doi:10.2196/12417

Continuous 7-Month Internet of Things-Based Monitoring of Health Parameters of Pregnant and Postpartum Women: Prospective Observational Feasibility Study

JMIR Form Res. 2020 Jul 24;4(7):e12417. doi: 10.2196/12417.

Authors

Johanna Saarikko¹, Hannakaisa Niela-Vilen¹, Eeva Ekholm^{2

3}, Lotta Hamari^{1

4}, Iman Azimi⁵, Pasi Liljeberg⁵, Amir M Rahmani⁶, Eliisa Löyttyniemi⁷, Anna Axelin¹

Affiliations

¹ Department of Nursing Science, University of Turku, Turku, Finland.
² Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland.
³ Faculty of Medicine, University of Turku, Turku, Finland.
⁴ Faculty of Communication Sciences, University of Tampere, Tampere, Finland.
⁵ Department of Future Technologies, University of Turku, Turku, Finland.
⁶ School of Nursing and Department of Computer Science, University of California, Irvine, CA, United States.
⁷ Department of Biostatistics, University of Turku, Turku, Finland.

PMID: 32706696
PMCID: PMC7414406
DOI: 10.2196/12417

Abstract

Background: Monitoring during pregnancy is vital to ensure the mother's and infant's health. Remote continuous monitoring provides health care professionals with significant opportunities to observe health-related parameters in their patients and to detect any pathological signs at an early stage of pregnancy, and may thus partially replace traditional appointments.

Objective: This study aimed to evaluate the feasibility of continuously monitoring the health parameters (physical activity, sleep, and heart rate) of nulliparous women throughout pregnancy and until 1 month postpartum, with a smart wristband and an Internet of Things (IoT)-based monitoring system.

Methods: This prospective observational feasibility study used a convenience sample of 20 nulliparous women from the Hospital District of Southwest Finland. Continuous monitoring of physical activity/step counts, sleep, and heart rate was performed with a smart wristband for 24 hours a day, 7 days a week over 7 months (6 months during pregnancy and 1 month postpartum). The smart wristband was connected to a cloud server. The total number of possible monitoring days during pregnancy weeks 13 to 42 was 203 days and 28 days in the postpartum period.

Results: Valid physical activity data were available for a median of 144 (range 13-188) days (75% of possible monitoring days), and valid sleep data were available for a median of 137 (range 0-184) days (72% of possible monitoring days) per participant during pregnancy. During the postpartum period, a median of 15 (range 0-25) days (54% of possible monitoring days) of valid physical activity data and 16 (range 0-27) days (57% of possible monitoring days) of valid sleep data were available. Physical activity decreased from the second trimester to the third trimester by a mean of 1793 (95% CI 1039-2548) steps per day (P<.001). The decrease continued by a mean of 1339 (95% CI 474-2205) steps to the postpartum period (P=.004). Sleep during pregnancy also decreased from the second trimester to the third trimester by a mean of 20 minutes (95% CI -0.7 to 42 minutes; P=.06) and sleep time shortened an additional 1 hour (95% CI 39 minutes to 1.5 hours) after delivery (P<.001). The mean resting heart rate increased toward the third trimester and returned to the early pregnancy level during the postpartum period.

Conclusions: The smart wristband with IoT technology was a feasible system for collecting representative data on continuous variables of health parameters during pregnancy. Continuous monitoring provides real-time information between scheduled appointments and thus may help target and tailor pregnancy follow-up.

Keywords: biosensing; cloud computing; heart rate; mHealth; physical activity; postnatal care; prenatal care; sleep; wearable electronics.

©Johanna Saarikko, Hannakaisa Niela-Vilen, Eeva Ekholm, Lotta Hamari, Iman Azimi, Pasi Liljeberg, Amir M Rahmani, Eliisa Löyttyniemi, Anna Axelin. Originally published in JMIR Formative Research (http://formative.jmir.org), 24.07.2020.