(1152) Effectiveness of remote digital home weight monitoring on gestational weight gain in obese patients

Abnormal weight gain in pregnancy is a frequent contributor to adverse maternal and fetal outcomes. We aim to determine the effectiveness of a digital remote weekly weight monitoring program (Connected MOM) to improve adherence to weight gain targets for obese pregnant patients.

Study Design:

This was a retrospective cohort study of patients with a pre-gestational body mass index greater than 30 who received prenatal care and delivered within a single hospital system from October 2016 to March 2022. Patients enrolled in Connected MOM were compared to routine care controls. Groups were matched in a 1:2 fashion based on age, pre gestational BMI, and insurance type. Primary outcome was adherence to the Institute of Medicine’s (IOM) recommended weight gain in pregnancy guidelines. Secondary outcomes included cesarean delivery, preterm delivery, small for gestational age infants, and perinatal death.

Results:

562 patients enrolled in Connected MOM were matched to 1,124 patients with standard prenatal care. Baseline differences were seen between groups after matching. The remote monitoring group contained a higher proportion of nulliparous patients while the group receiving routine care contained a higher proportion of Black patients and tobacco users (Table 1). The remote weight monitoring group did not demonstrate improved adherence to IOM recommendations (51% vs 52% above target, OR 0.95, CI 0.78-1.17, Table 2). Median weight gain during pregnancy was similar between groups (21 vs 21 pounds, p 0.42). When stratified by BMI class, remote monitoring was still not associated with IOM adherence or decreased weight gain. Outcomes including cesarean delivery, preterm birth, small for gestational age, and perinatal death were all similar between groups (Table 2).

Conclusion:

Home weight monitoring alone in obese patients did not improve adherence to recommended gestational weight guidelines. In addition, enrollment in remote monitoring did not improve other perinatal outcomes. This study reveals a need for additional investigation of interventions that may aid in adherence to gestational weight guidelines.