The Effects on Inappropriate Weight for Gestational Age of an SMS Based Educational Intervention for Pregnant Women in Xi’an China: A Quasi-Randomized Controlled Trial

Zhongliang Zhou, Yanfang Su, Jesse Heitner, Yafei Si, Dan Wang, Zhiying Zhou and Changzheng Yuan
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Zhongliang Zhou: School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, Shaanxi, China
Yanfang Su: School of Medicine, University of Washington, Seattle, WA 98195, USA
Jesse Heitner: Aceso Global, Washington, DC 20036, USA
Yafei Si: School of Risk and Actuarial Studies and CEPAR, University of New South Wales, Sydney, NSW 2052, Australia
Dan Wang: School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, Shaanxi, China
Zhiying Zhou: School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, Shaanxi, China
Changzheng Yuan: The Children’s Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, Zhejiang, China

IJERPH, 2020, vol. 17, issue 5, 1-11

Abstract: Background: The aim of this study was to estimate the effects of maternal text messages on inappropriate weight for gestational age (IWGA) in newborns in rural China. Methods: Participants were pregnant women presenting for antenatal care at a Maternal and Child Health Center in Xi’an, China during the 2013–2015 period. In total, 2115 women completed the program with follow-up information included in the final analyses. All mothers were divided into four groups, including (1) a control group that received only a few “Basic” messages, (2) a Care-Seeking (CS) message group, (3) Good Household Prenatal Practices (GHPP) message group, and (4) a group receiving all 148 text messages. The primary outcome was IWGA, including small for gestational age (SGA) and macrosomia (weighing ≥4000g at birth). Multivariable logistic regression using an intent-to-treat estimate was utilized. Results: In total, 19.5% of newborns were IWGA. The risk of IWGA was 23.0% in the control group, 19.6% in the CS group, 18.9% in the GHPP group, and 16.5% in the group with All Texts. Compared to the control group, the odds ratio of IWGA was 0.65 (0.48–0.89) for the group receiving All Texts, which remained statistically significant after performing the Holm-Bonferroni correction. The odds ratio of macrosomia was 0.54 (0.34–0.87) and 0.57 (0.36–0.49) for the Care Seeking message group and the All Texts group, respectively, with statistical significance. Conclusion: A package of free informational text messages, including advice for good household prenatal practices and care seeking, may prevent the inappropriate weight for gestational age through a protective effect on macrosomia. Advice to encourage care seeking in pregnancy may prevent macrosomia among neonates in rural China as well.

Keywords: inappropriate weight for gestational age; short message service; quasi-randomized controlled trial; mhealth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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