INTRODUCTION:
Excessive weight gain and high blood pressure are strong risk factors for pregnancy outcome. Mobile applications are increasingly posited to facilitate a high-resolution, bidirectional exchange between physician and patient. We developed an integrated system of mobile applications that incorporates remote patient monitoring together with an algorithm for triage system alerts (“triggers”) on deviation from established American College of Obstetricians and Gynecologists clinical guidelines. This study aimed to determine the efficacy and accuracy of our integrated system in regard to home vital sign measurement, triggers, and clinical measurements used in prenatal care.
METHODS:
We validated our trigger algorithm through 38 random simulations of longitudinal weight and blood pressure data. To demonstrate clinical utility, six low-risk obstetric patients owning iPhone devices received a U.S. Food and Drug–approved Wi-Fi sphygmomanometer and weight scale together with a mobile app that integrated the data and provided prenatal educational material. Participants were asked to record weekly measurements. Weight and blood pressure baselines were calculated through the mobile app and compared with in-clinic measurements to evaluate trigger alerts.
RESULTS:
Remote digital data collection was successful, with all participants recording both metrics with a frequency of more than once a week. Remote measurements fell within the 95% confidence interval of clinical measurements. The trigger system produced zero false-positive and zero false-negative results.
CONCLUSION:
Pregnant participants demonstrated ability and compliance using digital devices for remote clinical monitoring. Remote readings were highly correlated to clinical measurements, demonstrating validity of remote devices in collecting high-resolution weight and blood pressure data. This model may have utility in monitoring and managing pregnant women between prenatal appointments.
