How APPropriate are physical activity apps for pregnant women: A systematic search and content analysis of evidence-based content, features of exercise instruction, and expert involvement

Purpose: Physical activity during pregnancy is associated with health benefits for both mother and child. Pregnant women are increasingly using mobile applications (apps) to access health-related information. However, the extent to which apps provide physical activity/exercise advice that aligns with current evidence-based pregnancy guidelines is unclear. The purpose of this study was to conduct the first systematic search and content analysis of apps that promote physical activity/exercise in pregnancy to examine the alignment of the content with current evidence-based physical activity guidelines, features and credentials of app developers. Methods: Systematic searches were conducted in the Australian AppStore and GooglePlay stores in October 2020. Apps were identified using search terms relevant to pregnancy and physical activity/exercise and screened for inclusion (free to download or did not require immediate paid subscription and an average user rating of 4+ out of 5). Each app was independently reviewed using an author-designed extraction tool. Data were exported, collated, and reported using descriptive statistics. Results: Twenty-seven apps were included in this review (GooglePlay: n=16 and AppStore: n=11). Seventeen apps provided some information relating to each of the FITT principles (frequency, intensity, time, type) of exercise; however, only three provided this information in-line with current evidence-based physical activity guidelines. Ten apps provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. No apps actively engaged in screening for potential contraindications. Only four apps collected information about the user’s current exercise behaviours, three apps allowed users to personalise features relating to their exercise preferences, and ten apps provided information about developer credentials. Conclusions: Few physical activity/exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. There is a need to improve the quality of apps that promote exercise in pregnancy, to ensure women are appropriately supported to engage in exercise, and the potential risk of injury, complications and/or adverse pregnancy outcomes for both mother and child is minimised. This could be done by providing expert guidance that aligns with current guidelines, introducing screening measures and features that enable personalisation and tailoring to individual users, or by developing a recognised system for regulating apps.