Abstract
Research question: Is an online lifestyle coaching platform more effective at modifying periconceptional behaviours than standard advice offered by the UK National Health Service (NHS)? Design: Women with subfertility or recurrent miscarriage were recruited to a two-centre randomized controlled trial. They were randomized to either the online lifestyle coaching platform Smarter Pregnancy (intervention) or periconceptional advice provided by NHS websites (control). Participants completed a lifestyle questionnaire at baseline, 6, 12, 18 and 24 weeks, and the results were used to tailor lifestyle coaching in the intervention group. At baseline, 12 and 24 weeks, composite risk scores (CRS) were calculated. A lower CRS corresponds to a healthier lifestyle. Results: Of the 400 women recruited, 262 women were randomized (131 in each arm). At 12 weeks, a reduction in CRS (includes risk score for intake of folic acid, vegetables and fruits, smoking and alcohol) was observed in the intervention versus control arms. After correcting for baseline, the difference in the CRS between intervention and control was –0.47 (95% CI –0.97 to 0.02) at 12 weeks and –0.32 (95% CI –0.82 to 0.15) at 24 weeks. A statistically significant reduction in lifestyle risk scores was found in women with a body mass index (BMI) of 25 kg/m2 or above compared with those with a BMI below 25kg/m2. The odds of being pregnant at 24 weeks was increased in the intervention versus control (OR 2.83, 95% CI 0.35 to 57.76). Conclusions: The Smarter Pregnancy coaching platform is more effective in delivering lifestyle advice and modulating behaviours to support women with a history of subfertility or recurrent miscarriage than standard online NHS advice.
| Original language | English |
|---|---|
| Pages (from-to) | 111-119 |
| Number of pages | 9 |
| Journal | Reproductive BioMedicine Online |
| Volume | 43 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jul 2021 |
Bibliographical note
Funding Information:The authors thank all the women who have participated in this randomized controlled trial. This study was funded by NIHR Southampton Biomedical Research Centre (Nutrition) and the Department of Obstetrics and Gynaecology at the Erasmus MC University Medical Center in Rotterdam, The Netherlands. Smarter Pregnancy is a commercial product and licenses to use the software under trial were purchased. The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author.
Publisher Copyright:
© 2021 Reproductive Healthcare Ltd.