Digital solutions for self-monitoring physical health and wellbeing during pregnancy

Perinatal disorders were among the top ten causes of global burden of disease in 2019. Better access to perinatal healthcare would help to reduce preventable morbidity. The increase in access to and use of smartphones presents a unique opportunity to transform and improve how women monitor their own health during pregnancy. This thesis aims to investigate the quality and usage of currently available pregnancy digital health tools for self-monitoring and to validate a newly developed, custom-built pregnancy self-monitoring tool. In Chapter 2, the most popular, commercially available pregnancy apps and their monitoring tools were evaluated for their quality by conducting a pregnancy app scoping review. In Chapters 3 and 4, pregnant women and healthcare professionals were surveyed and interviewed to better understand their usage of and attitudes towards digital health, as well as their thoughts about two hypothetical app features (a direct patient-to-healthcare professional communication tool and a novel body measurement tool). In Chapter 5, we test the performance of a first generation, custom-built body measurement tool (which we called BMT-1) by comparing the digital measurements extracted from photos taken on smartphones to physical measurements taken with measuring tape. The performance of BMT-1 was also assessed on a longitudinal set of digitally constructed pregnancy models. Collectively, the findings from Chapters 2, 3 and 4 provide evidence that there is both opportunity and scope for the development of new digital health tools to support and enhance the quality of care during pregnancy. The results from Chapter 5 indicate that BMT-1 successfully extracted body measurements from both photos and digitally constructed pregnancy models, though would require refinement before it could be launched. To finalise, in Chapter 6, I outline how these findings could help to guide the design, development and implementation of new pregnancy digital health tools