Effect of Educational Short Message Service (SMS) on Excessive Gestational Weight Gain (GWG)

Abstract

Objectives The objective of this trial was to investigate the effect of educational short message service (SMS), or text messages, on gestational weight gain (GWG) in a low-income population. It was expected that the intervention group, which received text messages on nutrition and physical activity during pregnancy, would experience less GWG when compared to the control group. Methods Participants (n = 83) were recruited at WIC clinics on the island of O‘ahu, Hawai‘i at 15–20 weeks gestational age. Eligibility criteria were: body mass index (BMI) of 25–45 kg/m2 in the first trimester, 18 years of age or older at the time of recruitment, and possession of a cellular phone with the ability to receive text messages. After recruitment, participants were randomized into intervention (n = 42) and control (n = 41) groups. The intervention group received SMS on nutrition and physical activity during pregnancy per the Institute of Medicine and American College of Obstetricians and Gynecologists guidelines, respectively. The control group received SMS about general health topics during pregnancy. Both groups received one text message per week for eighteen weeks. GWG was defined as the difference between the last weight taken before delivery and participants’ self-reported weight before pregnancy. GWG in intervention and control groups was compared using a linear regression model. Results Women were age 27.7 ± 5.3y on average, 65.5% were Native Hawaiian, Pacific Islander or American Indian, 54.8% had some college or more and 37.8% were employed. The average weight before pregnancy was higher in the intervention group (80.6 + 17.7 kg) than that in the control group (76.2 + 15.9 kg), but this difference was not significant (P = 0.24). GWG was lower in the control group (14.1 + 11.4 kg) compared to the intervention group (15.5 + 11.6 kg), but this result was not significant (P = 0.58). Conclusions There was no significant difference in gestational weight gain between the intervention and control groups. Trials that begin earlier in pregnancy or before pregnancy with longer interventions and more frequent messages are needed. Funding Sources Mountain West Clinical Translational Research Infrastructure Network under a grant from the National Institute of General Medicine Sciences of the National Institutes of Health.