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The role of lifestyle interventions in high-risk pregnancies

  • Apps, Databases, and Digital Health
  • Helping Patients to Manage Their Own Conditions
  • Self-managament
  • Weight, Health, and Behaviour

Pregnant women with chronic hypertension face an increased risk of complications, yet there is little evidence on how to best support them in adopting healthy lifestyle behaviours. This study aimed to fill that gap by exploring current clinical guidelines, patient experiences, and digital interventions to optimise lifestyle support during pregnancy.

The project involved three main components:

  1. A systematic review of existing studies on lifestyle interventions and their impact on blood pressure and weight management in pregnancy.
  2. A review of clinical guidelines to assess current recommendations for weight and lifestyle management during pregnancy.
  3. Development and testing of a digital lifestyle intervention (DAPHNY App) co-designed with pregnant women and healthcare professionals.

The study used mixed methods, including surveys, focus groups, and feasibility testing, to ensure the intervention was both evidence-based and user-friendly.

Impact and Implementation

The study raised awareness of the need for lifestyle support in antenatal hypertension management and contributed new evidence on how digital tools could help.

Findings suggest that embedding lifestyle support into existing self-monitoring blood pressure apps could be a practical and scalable solution. However, integration with clinical systems, training for healthcare professionals, and patient engagement strategies are needed for successful implementation.

The research has already influenced discussions in NHS maternity care, and the DAPHNY App provides a foundation for future trials.

Next Steps

  • Conduct a feasibility trial to test the integration of lifestyle support within existing hypertension self-monitoring apps.
  • Develop training for healthcare professionals to help them deliver personalised lifestyle advice.
  • Explore alternative antenatal care models that support health promotion alongside medical management.
  • Investigate ways to integrate digital interventions with NHS electronic health records and activity trackers.

Project lead / contact: Lucy Goddard — Nuffield Department of Primary Care Health Sciences, University of Oxford

ARC theme: Patient Self-Management

Completed Project

Key Findings

  • Lack of evidence: Few studies have examined lifestyle interventions for pregnant women with chronic hypertension, highlighting a major gap in research.
  • Inconsistent clinical guidance: Guidelines for weight and lifestyle management during pregnancy varied widely and often emphasised risk rather than practical support.
  • Gaps in routine care: Although many women were motivated to adopt healthier behaviours, less than half recalled receiving any lifestyle advice from healthcare professionals.
  • DAPHNY App development: A lifestyle intervention app was co-designed with 21 women and 23 healthcare professionals. It was well-received as a useful and engaging tool but needed integration with self-monitoring blood pressure apps and clinical pathways for maximum impact.
  • Healthcare system barriers: Lifestyle support is not currently embedded in routine antenatal hypertension care due to time constraints, biases, and a focus on medical management.

Who we worked with

  • Oxford University Hospitals NHS Foundation Trust

  • Manchester University NHS Foundation Trust

  • Department of Engineering, University of Oxford
  • Nuffield Department of Population Health, University of Oxford