Magee and CMU researchers are developing an innovative app to combat preterm birth

A team of Pittsburgh researchers is developing a way to put information and support directly into the hands of women with high-risk pregnancies.

Maternal-fetal medicine specialists at Magee-Womens Hospital of UPMC and decision scientists at Carnegie Mellon University are creating a yet-to-be-named smartphone app to provide personalized obstetrical care specifically targeting preterm birth risk.

“The app was designed using a scientific process and included target users in the design process,” says Tamar Krishnamurti, assistant research professor of engineering and public policy at CMU. “It is able to provide personal feedback rather than the more general advice other apps offer.”

In the United States, one of every 10 births occurs before 37 weeks of gestation. Preterm birth rates are higher among families living in poverty, who also are the hardest to reach due to limited access to prenatal care.

An app can help reach high-risk patients because of the widespread use of mobile phones across all populations. About 86 percent of American adults own a mobile phone, and 20 percent of smartphone users downloaded a pregnancy app in 2015, Krishnamurti says.

The research team identified 16 study participants from Magee’s outpatient clinic, which specializes in high-risk pregnancies, and provided each with a smartphone preloaded with the app and a digital weight scale.

Over three months, participants used the app to assess such risk factors as rate of weight gain, smoking, alcohol consumption, depression and partner violence. The app then delivered patient-specific risk feedback and recommendations, pregnancy education, reminders about appointments and fetal health monitoring aids. The app is also able to send real-time alerts to medical staff when it detected signs of abuse or suicidal tendencies.

Dr. Hyagriv Simhan, chief of the Division of Maternal-Fetal Medicine at Magee, says women are often not aware of the risk factors and symptoms associated with pregnancy complications.

“The app’s educational components and symptom tracker features are intended to help a woman distinguish normal from not normal, and will prompt a provider evaluation when indicated,” he says.

“Our app is intended to provide vetted expert educational content combined with personalized risk assessment. It can be used throughout pregnancy and improves engagement in the prenatal experience.”

Free transportation using Uber also was incorporated into the app’s functionality.

“When speaking with the women about why they miss appointments, many said they had difficulty finding transportation,” says Krishnamurti. “From some Pittsburgh neighborhoods, it takes two buses or a walk up a big hill to get to Magee. Depending on the season or if the woman has other children, these might not be feasible ways to get to an appointment.”

If the app eventually becomes available through hospital systems, Krishnamurti says, it would be “wonderful” if the Uber feature could remain available to users. Study participants who used Uber had an attendance rate of 89 percent at prenatal appointments, well above the clinic norm of 50 percent.

The app is not yet publicly available as researchers are now focusing on a pilot involving a much larger population in the Pittsburgh area. The ultimate goal, Krishnamurti says, is to make it available to women all over the world.

She says while the app does offer specific feedback for high-risk pregnancies, all women can benefit from its functionality.

“Pregnancy is a time when everyone feels worried and concern,” she says. “The app is something that can give feedback even if everything is going well with a low-risk pregnancy.”