GestNaP: your pregnancy advisor

Obesity and sedentarism are highly prevalent in South America and low and middle income countries. Pregnant women exposed to this factors, may develop poor maternal and fetal outcomes, such as impaired cognitive development, growth and increased cardiovascular risk in adulthood. Both conditions are associated to low socioeconomic level and poor public health schemes.This situation increases inequality. Besides socioeconomic condition and opportunities to access public health, in countries with high sedentarism and obesity rates, most people have access to smartphones and internet. According this, we propose to develop an application where pregnant women can find trust information and advices according to their reality, such as daily diet and exercise plan. Furthermore, it will create a profile with prenatal supervision data such as blood analysis provided by health professionals. This app will improve daily quality life during pregnancy and maternal and fetal outcomes at short, mid and long term, reducing inequality. 

Evidence suggests that middle and low-income countries such as in South America are facing the growing epidemic of comunicable and non-communicable diseases, creating a burden on their economy and healthcare system. Also, high rates of obesity and sedentarism during pregnancy are detrimental for both, mother and fetus. Mother may develop gestational diabetes and preclampsia, in addition to high risk of heart disease and hypertension after birth. Moreover, the fetus may develop short, mid and long term consequences, such as increased perinatal morbidity, impaired cognitive development and increased risk of cardiovascular disease in adulthood. These conditions are associated with low socioeconomic level. People with low incomes has less access to: education, healthy food, playgrounds and squares. Despite care in Chile is providing by midwives who develop an amazing work, time and resources as well as ministerial recommendations to promote appropriate physical activity and nutrition during pregnancy are scarce. 

GestNaP will provide advices easy to follow and according to people reality, with focus on time, food and environment where people lives. Also, pregnant women will had a profile which allows a better follow up of gestation, leading to a better control of weight gain, improvement of cardiovascular health and fetal outcomes 

GestNaP will be a user friendly mobile application which improve antenatal supervision and pregnancy outcomes. GestNaP will provide a user profile which will allow pregnant woman to maintain a progress about antenatal visits, weeks of gestations, weight gain, pregnancy pathologies, ultrasounds data, among others. Also, health professionals will be able to complete relevant information such as blood analyses results and follow up gestational data. Furthermore, this app will provide information about physiological changes during pregnancy in a language according to user educational level. However, the most important function are the dietary and physical activity recommendations adjusted according to woman resources and pregnancy status.  This app will provide a detailed guide of what to eat with several menus peer week as well what kind of physical activity is recommendable according to gestational age and woman health. Finally, the data obtained from this app will allow to create better statistics about pregnant woman characteristics in the population where it will be used, which will provide a better knowledge about woman necessities as well as prevalence of pregnancy complications, to put special attention and focus efforts to improve maternal and fetal care.

The people benefited from the use of this application will be those with a low and middle socioeconomic incomes, that cannot afford antenatal supervision in private health system. As a midwife who worked in public health system, I know that most women are trapped in environments where is too hard to have a healthy lifestyle. Generally, they only can afford cheap unhealthy food, and they have not access to gym or implements to do exercise frequently.They have jobs inside or outside home which takes a big part of their day, keeping them without possibility to train or dedicate time to themselves. Previously to develop this application, we will do a survey to determine the specifics needs of these women, including characteristics that would made the application user friendly. By the moment, according to field work we know that most of them are very familiarized with social media apps, expending a lot of time using it. Also, we know that when they have questions, they look for answers in web pages that not always have trust information. According this, we think that this app will allow people to learn and follow trust recommendations in an easy way according to heir reality. 

Antenatal supervision is essential for optimal outcomes during pregnancy. Public health system has limited resources which prevent an integral antenatal supervision, forgetting basics issues such as nutrition and physical activity. Even more, people with more access to healthy food and physical activity frequently is from higher socioeconomic levels. Because of that, for low incomes people, to use an app which improve the access to trust information and more important, information according their reality, will improve maternal care, as well as fetal outcomes. There is increasing evidence that antenatal care is essential for health of the newborn across his entire life. 

We know a lot of mobile apps to track several variables such as menstrual cycle, food intake, steps counters and even gestation age during pregnancy. However, we are proposing an app which not only will integrate all of them, but also in the future it would be connected with the primary health system, leading to a better centralization of information. But the most innovative aspects of GestNaP is its customized advice system, which takes all the data available in the app to figure out nutritional and physical activity advices during pregnancy according to women reality, as well as general information about pregnancy related issues.

Mobile applications use to be user friendly and used by most of people worldwide. Our idea is to develop an app which set profiles and would delivery trust information not only in a friendly way but also customized according to user reality, such as educational level, available resources and socioeconomic level. 

Currently, several studies reported that mobile apps may improve antenatal care, however, there is no apps with the same features proposed

https://pubmed.ncbi.nlm.nih.gov/30698533/

https://pubmed.ncbi.nlm.nih.gov/31718627/

https://pubmed.ncbi.nlm.nih.gov/31201201/

Our strategy is based on the follow logical framework:

The problem: pregnant women with low access to healthy food, physical activity instructions, trust information and low incomes. 

What do they need?: not only the general advices provided by the health system, but also customized advices according their reality, providing affordable solutions to their problems.

What we will do?: provide an app which set a profile of every women and provide customized advices. Also, this will be connected with the health system, allowing midwives to participate from a more integral antenatal care. 

Outcomes: In short term we expect to see and improvement in prenatal lifestyle as well as maternal and fetal outcomes, such as less pregnancy complications and perinatal morbidity. In mid and long term we expect a decrease in mothers risk of diabetes and hypertension, whereas in the offspring we expect an improve in neurodevelopment as well as a decrease in cardiovascular risk in adulthood.

We hope to develop the app the next year and start the trial process. After it we hope to integrate the app to the public health system in Santiago, Chile. If it works as we want, in five years we could be working at national level.

The main barriers in our project are the cost of develop the mobile app and the acceptability in the health care national system 

Besides the cost of develop our app is not extremly high, it is an important issue to resolve. According this we are assessing the possibility of collaborate with software engineer faculty, which allows us to develop a high quality app at a lower price. 

Regarding national health care national system acceptability, we hope that after the trial period we reach out solid outcomes who convince authorities to invest in our project

While we have been developing the mobile app the team will be: 

Co-founders (full-time staff): 2

Obstetricians (part-time staff): 2 

Midwives  (part-time staff): 2

Software developer (full-time staff): 1 

Software developer (contractors): 1 

We are a team of maternal-fetal medicine researchers and health professionals from midwives to Ph.D. who work in one of the best university of the country. Some of us with international recognition and well-establish networks that facilitates the access to the most actualized information about antenatal care.

Some of us are part of University of Chile and University of O'higgins which we hope to collaborate in 2 aspects: 

1. Developing mobile app with software development students (University of Chile)

2. Testing the mobile app in university related health care centres which are part of public health system (University of Chile and University of O'higgins)