Needs, expectations and use of pregnancy apps: a cross-sectional study among Flemish pregnant women (Preprint)

BACKGROUND There is an exponential growth in the availability of mobile Health (mHealth) applications, resulting in increased use of pregnancy apps. However, the actual use, experience, and characteristics of women using pregnancy apps are relatively unknown. OBJECTIVE To map the current use of the Internet and mobile applications and the needs and expectations among pregnant women in Flanders. METHODS A cross-sectional study was conducted, using a semi-structured survey (April - June 2019) consisting of four different domains: (1) demographics; (2) use of multimedia; (3) sources of information; and (4) use of pregnancy apps. Women were recruited by social media, flyers, and paper questionnaires at prenatal consultations. Statistical analysis was mainly focused on descriptive statistics. Differences in continuous and categorical variables were tested using Independent Student’s t-tests and Chi-square tests. Correlations were investigated between maternal characteristics and the women’s responses. RESULTS In total, 311 women fulfilled the questionnaire completely. The majority of multimedia were daily used by the women (computer/laptop 40,84%; GSM: 80,71%; and smartphone/iPhone: 97,43%). The obstetrician was their prior source of information (86.17%), followed by ‘websites/Internet’ (85.85%) and ‘apps’ (74.92%). Information was mostly searched about the development of the baby (88.45%), discomfort/complaints (80.71%) and health during pregnancy (79.74%), administrative/practical issues (74.92%) and breastfeeding (56.59%). About half of the women (55.31%) downloaded a pregnancy app (172/311), mostly searched app stores (43.02%; 74/172). Singleton pregnancies asked significantly more information to their mother (73.33%) or other family members (43.33%) than married women (mother (in law): 51.26% (p= 0.02); family members: 21.88% (p = 0.01)) or cohabiting women (mother (in law): 50.00% (p = 0.02)). Pregnant women with lower education had significantly more a pc or laptop than those with higher education (98.63% vs. 85.47%; p = 0.008), consulted more other family members for pregnancy information (41.10% vs. 23.08%; p <0.01) but less a gynaecologist (95.89% vs. 83.54%; p = 0.001), followed more prenatal sessions (80.77% vs. 32.48%; p = 0.04) and searched more for information on discomfort/complains during pregnancy (89.04% vs. 79.49%; p = 0.02). Compared to multigravida, primigravida asked more advice about their pregnancy to their environment (family members: primigravida: 40.37% vs. multigravida 20.10%; p < 0.001; or other pregnant women: primigravida: 53.21% vs. multigravida 40.20%; p < 0.03). CONCLUSIONS Healthcare professionals need to be aware that mHealth apps are important and are a growing source of information for pregnant women. Concerns rise about the quality and safety of those apps, as only a limited amount of apps are subjected to an external quality check. Therefore, it is important that caregivers refer to high quality digital resources and take the opportunity to discuss digital information with pregnant women. CLINICALTRIAL The study was approved by the Medical Ethics Committees of the hospital Oost-Limburg (no. 19/0026U, B-no. B371201939699) and Ghent University hospital (EC 2018/0120, B-no. B670201835156).