Grant: Project Grant

Excess weight and low physical activity can lead to diabetes and high blood pressure, major causes of heart, brain, kidney, and eye disease. Pregnancy is a good time to take preventive action because there are signals of future risk and expectant parents are motivated to work towards better health for their children. The signals include 'temporary' diabetes and 'temporary' high blood pressure, which can come back in future pregnancies and may lead to 'permanent' diabetes and high blood pressure. Extra weight before pregnancy is also a signal, often with sugar and blood pressure levels that are in the high normal zone. Besides leading to longer term problems, these factors can affect parent and child health during pregnancy. The pregnant parent can develop complicated high blood pressure with blood vessel damage in many parts of the body and the child may not grow properly, may be premature, and may require intensive care. To prevent these pregnancy and later problems, we want to help pregnant persons walk more and gain weight within the recommended levels for pregnancy. We will focus on pregnant persons who have extra weight, temporary diabetes, and/or temporary high blood pressure in a previous pregnancy. We will give all of them a step counter that sends data to a secure online diary. We will send half of them targets for their steps each week, based on an algorithm we developed and tested. Whether or not a person gets the targets will be decided randomly, through a flip of a virtual coin. We will look at if the people in the step target group have less diabetes in pregnancy, high blood pressure in pregnancy, babies that are not delivered prematurely, babies that are not larger or smaller than considered best for health, and less need for intensive care (parent or baby).