Background Despite the availability of thousands of health apps worldwide, when considering those addressing children’s first 1000 days of life, most apps fail to consider the continuity between the prenatal and postnatal stages, and their joint impact on maternal and child health. The reliability, quality, and effectiveness of these apps are largely unknown, and the provided content seems questionable in terms of completeness, updating, and trustworthiness. Objective This study evaluates available Italian pregnancy and postnatal care apps to highlight the main gaps to be overcome and the resulting future challenges to be met in this mobile health–related field. Methods A systematic search was conducted on the Apple App Store and Google Play Store, and basic information was collected for all identified apps. After deduplication and further selection based on the exclusion criteria, an in-depth analysis of each app was performed by two researchers independently. A 71-item six-domain questionnaire about the desirable features of apps was used to assess information, functionalities, and technical features, while the Mobile Application Rating Scale (MARS) was employed for app quality evaluation. Results From an initial sample of 684 apps, 22 were deeply analyzed. Most apps did not fulfill the expectations, as just one achieved 50% of all desirable aspects. Postnatal care and counselling for both the mother and child was the least accomplished domain. Moreover, the quality of app information was generally rated more negatively than the quality of their functionality and esthetic features. The lacking aspects were information about methods for postpartum family planning and birth spacing (1/22, 5%) and immunization (2/22, 9%). Conclusions The identified gaps could serve as a basis for designing and implementing increasingly high-quality, targeted, and effective apps for pregnancy and postnatal health care, which provide comprehensive, reliable, and evidence-based information, as well as appropriate esthetic and functional characteristics, with relevant implications in terms of maternal and newborn health prevention and promotion.

BACKGROUND Despite thousands of health apps available worldwide, when considering on those addressing children’s first 1000 days of life most of them fail to consider the continuity between prenatal or postnatal stages and their joint impact on maternal and child health. Their reliability, quality and effectiveness are largely unknown as well as the provided contents seem questionable in terms of completeness, updating and trustworthiness. OBJECTIVE This review evaluates available Italian pregnancy and postnatal care apps, to highlight the main gaps to be overcome and the resulting future challenges to be met in this m-health-related field. METHODS A systematic review was conducted on iOS and Android stores and basic information set was collected for all resulting apps. After de-duplication and further selection based on inclusion/exclusion criteria, an in-depth analysis of each was performed by two researchers independently. A 71-items with six domains questionnaire about apps desirable features was used to assess information, functionalities, and technical features while MARS was employed for app quality evaluation. RESULTS From initial 684 apps, 22 of them were deeply analyzed. Most apps did not fulfill the expectations, as just one of them achieved the 50% of all desirable aspects. Postnatal care and counselling for both mother and child was the least accomplished domain. Moreover, the quality of apps information was generally rated more negatively than quality of their functionality and aesthetics features. Particularly lacking aspects include information about methods for postpartum family planning and birth spacing (4.5%) and immunizations (9.1%). CONCLUSIONS The identified gaps could serve as a basis for designing and implementing increasingly high-quality, targeted, and effective apps for pregnancy and postnatal health care, that provide comprehensive, reliable, and evidence-based information as well as appropriate aesthetic and functional characteristics, with relevant implications in terms of maternal and newborn health prevention and promotion.

Background Within the growing availability of health apps worldwide, apps for pregnancy and postnatal care still raise critical issues. The content they provide might rise some concerns in terms of quality, completeness, as well as practical implications for effective prevention and health promotion. This study aims at evaluating free pregnancy and postnatal care apps available in Italian language, shedding light on the main shortcomings and future challenges in this public health field. Methods Between July and November 2020, a multidisciplinary research group conducted a systematic review on iOS and Android stores. Data about information, functionalities and technical features of the apps were collected through a 71-items questionnaire including six domains: pregnancy and postnatal care and counselling, reminders and push notifications, notes and records, social support, and technical features. Results From 684 identified apps, 22 were deeply analyzed. Resulting apps did not include most desirable features, with just one achieving the 50% of them. The most lacking domain was postnatal care and counselling (17.3%), with particularly scarce information about immunizations that mothers or newborns need (9.1%). Information about free-of-charge and upon payment clinical exams during pregnancy is also absent in half of the apps. Moreover, most apps did not provide users social support with other mothers nor with the healthcare professionals (95.5%). Finally, just one app was CE marked as a medical device. Conclusions The identified gaps highlight large room for improvement in the use of pregnancy and postnatal care apps for prevention and health promotion. More efforts are needed to design and implement increasingly high-quality apps providing information related to preventive or diagnostic medical practices, as well as social and certified mechanism to interact with healthcare staff. Key messages Increase in use of pregnancy and postnatal care apps should be considered as an opportunity for public health in terms of prevention and health promotion. Providing appropriate information as well as social mechanism to interact with healthcare staff could help to direct mothers and mothers-to-be to the most suitable screening and therapeutic paths.