| Eligibility |
Inclusion Criteria:
- Age 18-50 years at time of enrollment
- Gestational age 10-20 weeks at time of enrollment
- Receiving primary care or prenatal care at Columbia/New-York Presbyterian site
- Planned delivery at Columbia/New-York Presbyterian with planned continuation of
primary care (postpartum and pediatric) at Columbia/New-York Presbyterian
- Ability to read and respond to questions in English or Spanish
- Smart phone ownership
- Willingness to receive information by smart phone for 18-month intervention and
follow-up duration
- Willingness to be randomized into an observational study or an intervention and
complete all study components
- Gives permission to participate in receiving messages to their smart phone and email
- Gives permission to complete all study procedures
- Has a physician's clearance for light to moderate physical activity
- Has an active email address
- Capable of providing informed consent
- Has access to Wi-Fi connection in their household
Exclusion Criteria:
- Multiple gestation
- Pre-pregnancy body mass index <18.5 kg/m2 >40
- Major fetal anomaly
- Fetal genetic abnormality
- Planned termination of pregnancy
- Chronic medical conditions that affect nutrition or prohibit regular exercise or alter
weight status such as:
- Diseases associated with glucose metabolism
- Diabetes (Type 1, type 2)
- Inflammatory Bowel Disease (Crohn's disease, ulcerative colitis)
- History of gastric bypass/gastric sleeve
- Uncontrolled thyroid disease (hypo or hyperthyroidism)
- Condition requiring enteral tube feeding
- Congenital or acquired heart disease that impacts nutritional needs and physical
activity ability
- HIV/AIDS
- Kidney disease
- Cancer
- Uncontrolled autoimmune disease
- Lupus
- Multiple sclerosis
- Sickle cell disease
- Zika infection
- Taking or planning to take certain prescription medications including high dose
glucocorticoids, atypical antipsychotics associated with weight gain (such as
risperdal (risperidone), clozapine (clozaril), olanzapine (zyprexa), quetiapine
(seroquel), etc.), or other prescription weight loss medications
- Personal history of breast cancer or any other type of cancer other than a basal cell
skin cancer
- Personal history of cardiovascular disease (coronary artery disease, congestive heart
failure, valvular heart disease, stroke, transient ischemic attack, or intermittent
claudication), kidney disease, liver disease, venous or arterial thromboembolic
disease, adrenal insufficiency, depression requiring hospitalization within the past 6
months, or non-pregnancy related illness requiring overnight hospitalization in the
past 6 months
- Underlying disease/treatment that might interfere with participation in/completion of
the study (e.g., significant gastrointestinal conditions, major psychiatric disorders,
and others at the discretion of the study clinician)
- Other active medical problems detected by examination or laboratory testing
- Inability to complete study visits or intervention components
- Unwillingness or inability to commit to a 18-month research study for them or their
child, including plans to move away
- Plans to be in a different geographic area within the next 2 years
- Unable to give informed consent
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