BACKGROUND
Mobile technology has the potential to supplement traditional prenatal care and improve screening and compliance with recommended screening tests. While previous research has shown high patient satisfaction with mobile technology in prenatal care, it remains unclear how integrating the recording of remote vital signs into pre-existing clinical workflows can enable improved clinical outcomes.
OBJECTIVE
In a multicenter retrospective study, we aimed to identify predictors of engagement with remote patient monitoring (RPM) using the Babyscripts™ digital health tool and to determine if low engagement correlated with adverse events.
METHODS
In a university-based obstetrics practice, pregnant patients were provided the Babyscripts™ mobile digital health platform alongside standard care. The digital health platform allowed for tracking of gestational weight gain and blood pressure and delivered timed education on expected symptoms and recommended screening tests during pregnancy. Patients were included in the study if they began using the RPM before the end of the first trimester and excluded if pregnancy outcomes were unavailable. We conducted a chart review of each patient’s prenatal care and delivery using trained abstractors and structured data collection forms. RPM engagement was defined as the number of weeks with at least one remote vital measurement. Outcomes such as pregnancy complications were considered individually and as a composite outcome. We employed multivariate logistic regression to identify predictors of engagement and complications.
RESULTS
Our study encompassed 823 patients, including 28% who identified as Black, 32% Medicaid/Medicare recipients, 43% over age 35, and 5% with a history of hypertension. Of these, 37 developed preeclampsia or pregnancy-induced hypertension, and 288 experienced at least one maternal complication. We discovered that age was positively associated with increased engagement (1.21%, 95% CI, 0.67-1.74%, increase per one-year increment in age). Conversely, belonging to a distressed community and greater than one prior full-term pregnancy was linked to reduced engagement, with decreases of 7.9% (95% CI: 1.2%-14.6%) and 12.16% (95% CI: 5.2%-19.1%) respectively. RPM engagement did not correlate with occurrence of pregnancy-related complications (OR = 1.006, 95% CI: 1.000-1.012).
CONCLUSIONS
In summary, lower engagement with an RPM appears to be connected to residence in a distressed community but not an increase in pregnancy complications. Increased age and first-time pregnancies were associated with higher RPM engagement. Future studies should assess whether engagement with prenatal care digital health platforms can modify risk factors for pregnancy complications.
CLINICALTRIAL
NA
