Goals for Reaching Optimal Wellness (GROWell): A clinical trial protocol of a digital dietary intervention for pregnant and postpartum people with prenatal overweight or obesity

Leigh Ann Simmons, Jennifer E Phipps, Courtney Overstreet, Paige M Smith, Elizabeth Bechard, Siwei Liu, Cheryl Walker, Devon Noonan, Leigh Ann Simmons, Jennifer E Phipps, Courtney Overstreet, Paige M Smith, Elizabeth Bechard, Siwei Liu, Cheryl Walker, Devon Noonan

Abstract

Background: Excess gestational weight gain (EGWG) is associated with multiple pregnancy complications and health risks for birthing people and their infants. Likewise, postpartum weight retention (PPWR), or not losing all pregnancy weight, has long-term health consequences. EGWG among people who enter pregnancy with overweight or obesity have worse obstetric outcomes and increased PPWR compared to women who gain within Institute of Medicine guidelines.

Methods: This study protocol describes the details of a blinded, randomized clinical trial of GROWell: Goals for Reaching Optimal Wellness, a mHealth tool designed to improve diet quality among people who enter pregnancy with overweight or obese BMIs to help them achieve appropriate GWG and safe postpartum pregnancy weight loss. Individuals with overweight and obesity will be randomly assigned to an attention control or intervention arm. The intervention group will receive personalized, goal-oriented text messages regarding dietary choices, while the attention control group will receive text messages about healthy pregnancy, labor, delivery, and early infancy. Both groups will complete online surveys at baseline, follow up, 3 and 6 months postpartum.

Results and discussion: Currently, 162 subjects have been enrolled. Outcomes associated with GWG and pregnancy are expected in late 2023, while outcomes on postpartum weight retention GROWell adherence are expected in late 2024. The results of this trial will support the use of an evidence-based mHealth tool to be integrated into clinical practice to reduce EGWG and PPWR among pregnant people with overweight and obese BMIs, a resource that is currently lacking.

Trial registration: ClinicalTrials.gov identifier: NCT04449432. Registered on June 26, 2020.

Keywords: Gestational weight gain; Mobile health intervention; Obesity; Overweight; Postpartum weight retention; Pregnancy.

Conflict of interest statement

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1.
Fig. 1.
Conceptual model for GROWell.
Fig. 2.
Fig. 2.
Overview of study design.
Fig. 3.
Fig. 3.
Example view of the mHealth platform and text messages.

References

    1. Smith KB, Smith MS, Obesity statistics, Prim Care. 43 (1) (2016) 121–135, ix.
    1. McDowell M, Cain MA, Brumley J, Excessive gestational weight gain, J. Midwifery Womens Health 64 (1) (2019) 46–54.
    1. Voerman E, Santos S, Golab BP, et al., Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: an individual participant data meta-analysis, PLoS Med. 16 (2) (2019) e1002744.
    1. Champion ML, Harper LM, Gestational weight gain: update on outcomes and interventions, Curr. Diab. Rep 20 (3) (2020) 11.
    1. Voerman E, Santos S, Inskip H, et al., Association of gestational weight gain with adverse maternal and infant outcomes, Jama. 321 (17) (2019) 1702–1715.
    1. Deputy NP, Sharma AJ, Kim SY, Hinkle SN, Prevalence and characteristics associated with gestational weight gain adequacy, Obstet. Gynecol 125 (4) (2015) 773–781.
    1. Baeten JM, Bukusi EA, Lambe M, Pregnancy complications and outcomes among overweight and obese nulliparous women, Am. J. Public Health 91 (3) (2001) 436–440.
    1. Cedergren M, Effects of gestational weight gain and body mass index on obstetric outcome in Sweden, Int. J. Gynecol. Obstet 93 (2006) 269–274.
    1. Crane JMG, White J, Murphy P, Burrage L, Hutchens D, The effect of gestational weight gain by body mass index on maternal and neonatal outcomes, J. Obstet. Gynaecol. Can 1 (2009) 28–35.
    1. Dietl J, Maternal obesity and complications during pregnancy, J. Perinat. Med 33 (2) (2005) 100–105.
    1. O’Brien TE, Ray JG, Chan WS, Maternal body mass index and the risk of preeclampsia: a systematic overview, Epidemiology. 14 (3) (2003) 368–374.
    1. Oken E, Rifas-Shiman SL, Field AE, Frazier AL, Gillman MW, Maternal gestational weight gain and offspring weight in adolescence, Obstet. Gynecol 112 (5) (2008) 999–1006.
    1. Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW, Gestational weight gain and child adiposity at age 3 years, Am. J. Obstet. Gynecol 196 (4) (2007) e1–e8.
    1. Olson CM, Strawderman MS, Hinton PS, Pearson TA, Gestational weight gain and postpartum behaviors associated with weight change from early pregnancy to 1 y postpartum, Int. J. Obes. Relat. Metab. Disord 27 (1) (2003) 117–127.
    1. Schack-Nielsen L, Michaelsen KF, Gamborg M, Mortensen EL, Sørensen TIA, Gestational weight gain in relation to offspring body mass index and obesity from infancy through adulthood, Int. J. Obes 34 (1) (2010) 67–74.
    1. Scholl TO, Hediger ML, Schall JI, Ances IG, Smith WK, Gestational weight gain, pregnancy outcome, and postpartum weight retention, Obstet. Gynecol 86 (3) (1995) 423–427.
    1. Soltani H, Fraser RB, A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum, Br. J. Nutr 84 (1) (2000) 95–101.
    1. Weiss JL, Malone FD, Emig D, et al., Obesity, obstetric complications and cesarean delivery rate–a population-based screening study, Am. J. Obstet. Gynecol 190 (4) (2004) 1091–1097.
    1. Kac G, Benicio MH, Velásquez-Meléndez G, Valente JG, Nine months postpartum weight retention predictors for Brazilian women, Public Health Nutr. 7 (5) (2004) 621–628.
    1. Linné Y, Dye L, Barkeling B, Rössner S, Weight development over time in parous women - the SPAWN study: 15 years follow-up, Int. J. Obes 27 (2003) 516–522.
    1. Soltani H, Fraser RB, A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum, Br. J. Nutr 84 (1) (2000) 95–108.
    1. Gore SH, Brown DM, West DS, The role of postpartum weight retention in obesity among women: a review of the evidence, Ann. Behav. Med 26 (2) (2003) 149–159.
    1. Gaillard R, Durmuş B, Hofman A, MacKenbach JP, Steegers EAP, Jaddoe VWV, Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy, Obesity. 21 (5) (2013) 1046–1055.
    1. Nehring I, Schmoll S, Beyerlein A, Hauner H, Von Kries R, Gestational weight gain and long-term postpartum weight retention: a meta-analysis, Am. J. Clin. Nutr 94 (5) (2011) 1225–1231.
    1. Mannan M, Doi SA, Mamun AA, Association between weight gain during pregnancy and postpartum weight retention and obesity: a bias-adjusted meta-analysis, Nutr. Rev 71 (6) (2013) 343–352.
    1. Hochner H, Friedlander Y, Calderon-Margalit R, et al., Associations of maternal prepregnancy body mass index and gestational weight gain with adult offspring cardiometabolic risk factors: the Jerusalem perinatal family follow-up study, Circulation 125 (2012) 1381–1389.
    1. Kaar JL, Crume T, Brinton JT, Bischoff KJ, McDuffie R, Dabelea D, Maternal obesity, gestational weight gain, and offspring adiposity: the exploring perinatal outcomes among children study, J. Pediatr 165 (3) (2014) 509–515.
    1. Mamun AA, Mannan M, Doi SAR, Gestational weight gain in relation to offspring obesity over the life course: a systematic review and bias-adjusted meta-analysis, Obes. Rev 15 (4) (2014) 338–347.
    1. Pugh SJ, Hutcheon JA, Richardson GA, M Brooks M, P Himes K, L Day N, M L BodnarGestational weight gain, prepregnancy body mass index and offspring attention-deficit hyperactivity disorder symptoms and behaviour at age 10, BJOG: Int. J. Obstetr. Gynaecol (2016).
    1. Pugh SJ, Richardson GA, Hutcheon JA, et al., Maternal obesity and excessive gestational weight gain are associated with components of child cognition, J. Nutr 145 (11) (2015) 2562–2569.
    1. Most J, Altazan AD, St Amant M, Beyl RA, Ravussin E, Redman LM, Increased energy intake after pregnancy determines postpartum weight retention in women with obesity, J. Clin. Endocrinol. Metab 105 (4) (2020) e1601–e1611.
    1. Kominiarek MA, Peaceman AM, Gestational weight gain, Am. J. Obstet. Gynecol 217 (6) (2017) 642–651.
    1. Quinlivan JA, Julania S, Lam L, Antenatal dietary interventions in obese pregnant women to restrict gestational weight gain to Institute of Medicine recommendations: a meta-analysis, Obstet. Gynecol 118 (6) (2011) 1395–1401.
    1. Flynn AC, Dalrymple K, Barr S, et al., Dietary interventions in overweight and obese pregnant women: a systematic review of the content, delivery, and outcomes of randomized controlled trials, Nutr. Rev 74 (2016) 312–328.
    1. Harrison CL, Lombard CB, Strauss BJ, Teede HJ, Optimizing healthy gestational weight gain in women at high risk of gestational diabetes: a randomized controlled trial, Obesity (Silver Spring) 21 (5) (2013) 904–909.
    1. Vinter CA, Jensen DM, Ovesen P, Beck-Nielsen H, Jorgensen JS, The LiP (lifestyle in pregnancy) study: a randomized controlled trial of lifestyle intervention in 360 obese pregnant women, Diabetes Care 34 (12) (2011) 2502–2507.
    1. Quinlivan JA, Lam LT, Fisher J, A randomised trial of a four-step multidisciplinary approach to the antenatal care of obese pregnant women, Aust. N. Z. J. Obstet. Gynaecol 51 (2) (2011) 141–146.
    1. Guelinckx I, Devlieger R, Mullie P, Vansant G, Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial, Am. J. Clin. Nutr 91 (2) (2010) 373–380.
    1. Vesco KK, Karanja N, King JC, et al., Efficacy of a group-based dietary intervention for limiting gestational weight gain among obese women: a randomized trial, Obesity (Silver Spring) 22 (9) (2014) 1989–1996.
    1. Soltani H, Duxbury AMS, Arden MA, Dearden A, Furness PJ, Garland C, Maternal obesity management using mobile technology: a feasibility study to evaluate a text messaging based complex intervention during pregnancy, J. Obes 2015 (814830) (2015) 1–10.
    1. Graham ML, Uesugi KH, Niederdeppe J, Gay GK, Olson CM, The theory, development, and implementation of an e-intervention to prevent excessive gestational weight gain: E-Moms Roc, Telemed. e-Health 20 (12) (2014) 1135–1142.
    1. Olson CM, Groth SW, Graham ML, Reschke JE, Strawderman MS, Fernandez ID, The effectiveness of an online intervention in preventing excessive gestational weight gain: the e-moms roc randomized controlled trial, BMC Pregnancy Childbirth. 18 (1) (2018) 148.
    1. Jackson RA, Stotland NE, Caughey AB, Gerbert B, Improving diet and exercise in pregnancy with video doctor counseling: a randomized trial, Patient Educ. Couns 83 (2) (2011) 203–209.
    1. Liu J, Wilcox S, Wingard E, Turner-McGrievy G, Hutto B, Burgis J, A behavioral lifestyle intervention to limit gestational weight gain in pregnant women with overweight and obesity, Obesity (Silver Spring) 29 (4) (2021) 672–680.
    1. Wilcox S, Liu J, Addy CL, et al., A randomized controlled trial to prevent excessive gestational weight gain and promote postpartum weight loss in overweight and obese women: health in pregnancy and postpartum (HIPP), Contemp. Clin. Trials 66 (2018) 51–63.
    1. O’Brien OA, McCarthy M, Gibney ER, McAuliffe FM, Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review, Eur. J. Clin. Nutr 68 (7) (2014) 760–766.
    1. Gyselaers W, Lanssens D, Perry H, Khalil A, Mobile health applications for prenatal assessment and monitoring, Curr. Pharm. Des 25 (5) (2019) 615–623.
    1. Chan KL, Chen M, Effects of social media and Mobile health apps on pregnancy care: Meta-analysis, JMIR Mhealth Uhealth. 7 (1) (2019), e11836.
    1. Guo H, Zhang Y, Li P, Zhou P, Chen LM, Li SY, Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus, J. Endocrinol. Investig 42 (6) (2019) 709–714.
    1. Head KJ, Noar SM, Iannarino NT, Harrington N Grant, Efficacy of text messaging-based interventions for health promotion: a meta-analysis, Soc. Sci. Med 97 (2013) 41–48.
    1. Poorman E, Gazmararian J, Parker RM, Yang B, Elon L, Use of text messaging for maternal and infant health: a systematic review of the literature, Matern. Child Health J 19 (5) (2015) 969–989.
    1. Edvardsson K, Ivarsson A, Eurenius E, et al., Giving offspring a healthy start: parents’ experiences of health promotion and lifestyle change during pregnancy and early parenthood, BMC Public Health 11 (2011) 936.
    1. Jones EJ, Fraley HE, Mazzawi J, Appreciating recent motherhood and culture: a systematic review of multimodal postpartum lifestyle interventions to reduce diabetes risk in women with prior gestational diabetes, Matern. Child Health J 21 (1) (2017) 45–57.
    1. Sattar N, Do pregnancy complications and CVD share common antecedents? Atheroscler. Suppl 5 (2) (2004) 3–7.
    1. van Rossem L, Wijga AH, Gehring U, Koppelman GH, Smit HA, Maternal gestational and Postdelivery weight gain and child weight, Pediatrics. 136 (5) (2015) e1294–e1301.
    1. Leonard SA, Rasmussen KM, King JC, Abrams B, Trajectories of maternal weight from before pregnancy through postpartum and associations with childhood obesity, Am. J. Clin. Nutr 106 (5) (2017) 1295–1301.
    1. Dewey KG, Effects of maternal caloric restriction and exercise during lactation, J. Nutr 128 (2 Suppl) (1998) 386s–389s.
    1. Bennett GG, Herring SJ, Puleo E, Stein EK, Emmons KM, Gillman MW, Web-based weight loss in primary care: a randomized controlled trial, Obesity 18 (2) (2010) 308–313.
    1. Bennett GG, Foley P, Levine E, et al., Behavioral treatment for weight gain prevention among black women in primary care practice: a randomized clinical trial, JAMA Intern. Med 173 (19) (2013) 1770–1777.
    1. Steinberg DM, Levine EL, Askew S, Foley P, Bennett GG, Daily text messaging for weight control among racial and ethnic minority women: randomized controlled pilot study, J. Med. Internet Res 15 (11) (2013) e244.
    1. Steinberg DM, Levine EL, Lane I, et al., Adherence to self-monitoring via interactive voice response technology in an ehealth intervention targeting weight gain prevention among black women: randomized controlled trial, J. Med. Internet Res 16 (4) (2014) e114.
    1. Herring SJ, Cruice JF, Bennett GG, Rose MZ, Davey A, Foster GD, Preventing excessive gestational weight gain among African American women: a randomized clinical trial, Obesity 24 (1) (2016) 30–36.
    1. Simmons LA, Beyond the genome: advancing precision medicine through personalized health behavior change interventions, in: Paper presented at: American Academy of Health Behavior Annual Scientific Meeting, 2017. Tucson, AZ.
    1. Bandura A, Social cognitive theory of self-regulation, Organ Behav. Hum. Dec 50 (2) (1991) 248–287.
    1. Hall PA, Fong GT, Temporal self-regulation theory: a model for individual health behavior, Health Psychol. Rev 1 (1) (2007) 6–52.
    1. Schnoll R, Zimmerman BJ, Self-regulation training enhances dietary self-efficacy and dietary fiber consumption, J. Am. Diet. Assoc 101 (9) (2001) 1006–1011.
    1. Ryan RM, Deci EL, Self-regulation and the problem of human autonomy: does psychology need choice, self-determination, and will? J. Pers 74 (6) (2006) 1557–1585.
    1. Implicit processes, self-regulation, and interventions for behavior change, Front. Psychol (2017), 10.3389/fpsyg.2017.00346.
    1. Ramage S, Farmer A, Eccles KA, McCargar L, Healthy strategies for successful weight loss and weight maintenance: a systematic review, Appl. Physiol. Nutr. Metab 39 (1) (2014) 1–20.
    1. Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM, The effects of exercise and physical activity on weight loss and maintenance, Prog. Cardiovasc. Dis 61 (2) (2018) 206–213.
    1. Rasmussen KM, Catalano PM, Yaktine AL, New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know, Curr. Opin. Obstet. Gynecol 21 (6) (2009) 521–526.
    1. Anderson Monica. U.S. Technology Device Ownership, Pew Research Center, 2015.
    1. Demographics of Mobile Device Ownership and Adoption in the United States, Pew Research Center. In, 2021.
    1. Burke LE, Wang J, Sevick MA, Self-monitoring in weight loss: a systematic review of the literature, J. Am. Diet. Assoc 111 (1) (2011) 92–102.
    1. Sarwer DB, von Sydow Green A., Vetter ML, Wadden TA, Behavior therapy for obesity: where are we now? Curr. Opin. Endocrinol. Diab. Obes 16 (5) (2009) 347–352.
    1. Baker RC, Kirschenbaum DS, Self-monitoring may be necessary for successful weight control, Behav. Ther 24 (3) (1993) 377–394.
    1. Coons MJ, Roehrig M, Spring B, The potential of virtual reality technologies to improve adherence to weight loss behaviors, J. Diabetes Sci. Technol 5 (2) (2011) 340–344.
    1. Dildy GA, Jackson GM, Fowers GK, Oshiro BT, Varner MW, Clark SL, Very advanced maternal age: pregnancy after age 45, Am. J. Obstet. Gynecol 175 (3 Pt 1) (1996) 668–674.
    1. Luke B, Brown MB, Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age, Hum. Reprod 22 (5) (2007) 1264–1272.
    1. Cnattingius S, Lambe M, Trends in smoking and overweight during pregnancy: prevalence, risks of pregnancy complications, and adverse pregnancy outcomes, Semin. Perinatol 26 (4) (2002) 286–295.
    1. Hammoud AO, Bujold E, Sorokin Y, Schild C, Krapp M, Baumann P. Smoking in Pregnancy Revisited: Findings from a Large Population-Based Study, Am. J. Obstet. Gynecol, 2005.
    1. Aubin HJ, Farley A, Lycett D, Lahmek P, Aveyard P, Weight gain in smokers after quitting cigarettes: meta-analysis, BMJ 345 (2012) e4439.
    1. Ferrara CM, Kumar M, Nicklas B, McCrone S, Goldberg AP, Weight gain and adipose tissue metabolism after smoking cessation in women, Int. J. Obes 25 (9) (2001) 1322–1326.
    1. Filozof C, Fernández Pinilla MC, Fernández-Cruz A, Smoking cessation and weight gain, Obes. Rev (2004).
    1. Nestler EJ, Barrot M, DiLeone RJ, Eisch AJ, Gold SJ, Monteggia LM, Neurobiology of depression, Neuron 34 (1) (2002) 13–25.
    1. Ouwens MA, van Strien T, van Leeuwe JFJ, Possible pathways between depression, emotional and external eating. A structural equation model, Appetite 53 (2) (2009) 245–248.
    1. Bennett GG, Foley P, Levine E, et al., Behavioral treatment for weight gain prevention among black women in primary care practice: a randomized clinical trial, JAMA Intern. Med 173 (19) (2013) 1770–1777.
    1. Steinberg DM, Levine EL, Lane I, et al., Adherence to self-monitoring via interactive voice response technology in an ehealth intervention targeting weight gain prevention among black women: randomized controlled trial, J. Med. Internet Res 16 (4) (2014) e114.
    1. Willcox JC, Campbell KJ, McCarthy EA, et al., Gestational weight gain information: seeking and sources among pregnant women, BMC Pregnancy Childbirth 15 (2015).
    1. Caut C, Leach M, Steel A, Dietary guideline adherence during preconception and pregnancy: a systematic review, Matern Child Nutr. 16 (2) (2020), e12916.
    1. George GC, Milani TJ, Hanss-Nuss H, Freeland-Graves JH, Compliance with dietary guidelines and relationship to psychosocial factors in low-income women in late postpartum, J. Am. Diet. Assoc 105 (6) (2005) 916–926.
    1. Gila-Díaz A, Witte Castro A, Herranz Carrillo G, et al., Assessment of adherence to the healthy food pyramid in pregnant and lactating women, Nutrients. 13 (7) (2021).
    1. Vadiveloo M, Parker H, Raynor H, Increasing low-energy-dense foods and decreasing high-energy-dense foods differently influence weight loss trial outcomes, Int. J. Obes 42 (3) (2018) 479–486.
    1. Freedland KE, Demanding attention: reconsidering the role of attention control groups in behavioral intervention research, Psychosom. Med (2013).
    1. Pagoto SL, McDermott MM, Reed G, et al., Can attention control conditions have detrimental effects on behavioral medicine randomized trials? Psychosom. Med 75 (2) (2013) 137–143.
    1. Popp L, Schneider S, Attention placebo control in randomized controlled trials of psychosocial interventions: theory and practice, Trials (2015).
    1. Krukowski RA, West DS, DiCarlo M, et al., Are early first trimester weights valid proxies for preconception weight? BMC Pregnancy Childbirth 16 (1) (2016) 357.
    1. Poston L, Bell R, Croker H, et al., Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial, Lancet Diabetes Endocrinol. 3 (10) (2015) 767–777.
    1. Soltani H, Duxbury AMS, Arden MA, Dearden A, Furness PJ, Garland C, Maternal obesity management using mobile technology: a feasibility study to evaluate a text messaging based complex intervention during pregnancy, J. Obes 2015 (2015).
    1. ACOG Committee Opinion No. 548, Weight Gain During Pregnancy, 2013.
    1. Flick AA, Brookfield KF, De La Torre L, Tudela CM, Duthely L, González-Quintero VH, Excessive weight gain among obese women and pregnancy outcomes, Am. J. Perinatol 27 (4) (2010) 333–338.
    1. Alberico S, Montico M, Barresi V, et al., The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study, Bmc Pregnancy Childb. 14 (2014).
    1. Subar AF, Kirkpatrick SI, Mittl B, et al., The automated self-administered 24-hour dietary recall (ASA24): a resource for researchers, clinicians, and educators from the National Cancer Institute, J. Acad. Nutr. Diet 112 (8) (2012) 1134–1137.
    1. Guenther PM, Kirkpatrick SI, Reedy J, et al., The healthy eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 dietary guidelines for Americans, J. Nutr 144 (3) (2014) 399–407.
    1. Miller PE, Mitchell DC, Harala PL, Pettit JM, Smiciklas-Wright H, Hartman TJ, Development and evaluation of a method for calculating the healthy eating Index-2005 using the nutrition data system for research, Public Health Nutr. 14 (2) (2011) 306–313.
    1. Rifas-Shiman SL, Rich-Edwards JW, Kleinman KP, Oken E, Gillman MW, Dietary quality during pregnancy varies by maternal characteristics in project viva: a US cohort, J. Am. Diet. Assoc 109 (6) (2009) 1004–1011.
    1. Ainsworth BE, Sternfeld B, Richardson MT, Jackson K, Evaluation of the Kaiser physical activity survey in women, Med. Sci. Sports Exerc 32 (7) (2000) 1327–1338.
    1. Schmidt MD, Freedson PS, Pekow P, Roberts D, Sternfeld B, Chasan-Taber L, Validation of the Kaiser physical activity survey in pregnant women, Med. Sci. Sports Exerc 38 (1) (2006) 42–50.
    1. Cox JL, Holden JM, Sagovsky R, Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale, Br. J. Psychiatry 150 (1987) 782–786.
    1. Eberhard-Gran M, Eskild A, Tambs K, Opjordsmoen S, Samuelsen SO, Review of validation studies of the Edinburgh postnatal depression scale, Acta Psychiatr. Scand (2001).
    1. Matthey S, Henshaw C, Elliott S, Barnett B, Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale - implications for clinical and research practice, Archiv. Women’s Mental Health 9 (6) (2006) 309–315.
    1. Matthey S, Using the Edinburgh postnatal depression scale to screen for anxiety disorders, Depress. Anxiety 25 (11) (2008) 926–931.
    1. Olander EK, Berg M, McCourt C, Carlström E, Dencker A, Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review, BMC Pregnancy Childbirth 15 (2015).
    1. Greaves CJ, Sheppard KE, Abraham C, et al., Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions, BMC Public Health 11 (2011).
    1. Kontos E, Blake KD, Chou WYS, Prestin A, Predictors of eHealth usage: insights on the digital divide from the health information national trends survey 2012, J. Med. Internet Res 16 (7) (2014) e172.
    1. ACOG Committee Opinion No. 549, Obesity in pregnancy, Obstet. Gynecol 121 (1) (2013) 213–217.
    1. Bogaerts A, Van den Bergh BRH, Ameye L, Witters I, Martens E, Timmerman D, Devlieger R. Interpregnancy Weight Change and Risk for Adverse Perinatal Outcome 5th, 122, Obstet. Gynecol, 2013, pp. 999–1009.
    1. Jain AP, Gavard JA, Rice JJ, Catanzaro RB, Artal R, Hopkins SA, The impact of interpregnancy weight change on birthweight in obese women, Am. J. Obstet. Gynecol 208 (3) (2013) 205.E1–205.E7.
    1. Villamor E, Cnattingius S, Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study, Lancet 368 (9542) (2006) 1164–1170.
    1. Noonan D, Simmons LA, Navigating nonessential research trials during COVID19: the push we needed for using digital technology to increase access for rural participants? J. Rural. Health 37 (1) (2020) 185–187.

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