Digital preconception interventions targeting weight, diet and physical activity: A systematic review

Hannah O'Connor; Jane C Willcox; Susan de Jersey; Charlotte Wright; Shelley A Wilkinson

doi:10.1111/1747-0080.12842

Digital preconception interventions targeting weight, diet and physical activity: A systematic review

Nutr Diet. 2023 Oct 16. doi: 10.1111/1747-0080.12842. Online ahead of print.

Authors

Hannah O'Connor^{1

2}, Jane C Willcox³, Susan de Jersey^{1

2}, Charlotte Wright⁴, Shelley A Wilkinson^{4

5

6}

Affiliations

¹ Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
² Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Butterfield Street Herston, Brisbane, Queensland, Australia.
³ Faculty of Health, Charles Darwin University, Darwin, Northwest Territories, Australia.
⁴ School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia.
⁵ Lifestyle Maternity, Brisbane, Queensland, Australia.
⁶ Department of Obstetric Medicine, Mater Mothers' Hospitals, Brisbane, Queensland, Australia.

PMID: 37845187
DOI: 10.1111/1747-0080.12842

Abstract

Aim: Optimising preconception health increases the likelihood of conception, positively influences short- and long-term pregnancy outcomes and reduces intergenerational chronic disease risk. Our aim was to synthesise study characteristics and maternal outcomes of digital or blended (combining face to face and digital modalities) interventions in the preconception period.

Methods: We searched six databases (PubMed, Cochrane, Embase, Web of Science, CINHAL and PsycINFO) from 1990 to November 2022 according to the PRISMA guidelines for randomised control trials, quasi-experimental trials, observation studies with historical control group. Studies were included if they targeted women of childbearing age, older than 18 years, who were not currently pregnant and were between pregnancies or/and actively trying to conceive. Interventions had to be delivered digitally or via digital health in combination with face-to-face delivery and aimed to improve modifiable behaviours, including dietary intake, physical activity, weight and supplementation. Studies that included women diagnosed with type 1 or 2 diabetes were excluded. Risk of bias was assessed using the Academy of Nutrition and Dietetics quality criteria checklist. Study characteristics, intervention characteristics and outcome data were extracted.

Results: Ten studies (total participants n=4,461) were included, consisting of nine randomised control trials and one pre-post cohort study. Seven studies received a low risk of bias and two received a neutral risk of bias. Four were digitally delivered and six were delivered using blended modalities. A wide range of digital delivery modalities were employed, with the most common being email and text messaging. Other digital delivery methods included web-based educational materials, social media, phone applications, online forums and online conversational agents. Studies with longer engagement that utilised blended delivery showed greater weight loss.

Conclusion: More effective interventions appear to combine both traditional and digital delivery methods. More research is needed to adequately test effective delivery modalities across a diverse range of digital delivery methods, as high heterogeneity was observed across the small number of included studies.

Keywords: digital health; maternal health; nutrition; physical activity; pre-pregnancy care; preconception.

Publication types

Review