Liang Yulian, Wang Shiying, Tao Jie, Yao Zheng, Yao Yongzi, Zhai Jinguo
Department of Obstetrics and Gynecology, Dongguan Hospital of Traditional Chinese Medicine, No. 3, Dongcheng Section, Songshanhu Avenue, Dongcheng Street, Dongguan, Guangdong, 523000, China.
School of Nursing, Southern Medical University, No. 1023, South Shatai Road, Baiyun District, Guangzhou, Guangdong, 510515, China.
BMC Nurs. 2025 Jul 3;24(1):829. doi: 10.1186/s12912-025-03379-0.
The incidence of postpartum symptoms such as prolonged lochia, constipation, fatigue, and depression remains high. Providing postpartum lifestyle interventions, including diet and exercise supervision, in clinical practice is challenging. A nurse-led app through diet supervision, exercise supervision and health education is a promising approach to lifestyle intervention.
This randomized controlled trial evaluated the effects of lifestyle intervention through app on postpartum women from January to November 2024. Postpartum women with aged 18-45 years, experiencing a single pregnancy without complications or co-morbidities, able to understand and use basic technologies such as smartphones and mobile apps were recruited from a tertiary hospital in China. A total of 150 participants were randomly allocated (1:1) to either an intervention group (n = 75) or a control group (n = 75). Due to the nature of the app-based intervention, blinding of participants and research staff was not possible. Occurrence of postpartum constipation, prolonged lochia, pelvic floor muscle dysfunction, sleep, fatigue and depression were collected at 42 days postpartum through checking the electronic medical record system or by electronic questionnaires.
Participants in the experimental and control groups were comparable at baseline. Among the 150 total participants, 61 (81.3%) and 63 (84%) successfully completed this study at 42 days postpartum after randomization. Participants in the intervention group showed the low occurrence of postpartum constipation (OR = 0.180, 95% CI: 0.038-0.857, P = 0.030) and prolonged lochia (OR = 0.220, 95% CI: 0.059-0.823, P = 0.025). Compared to the control group, participants in the intervention group showed significant improvements in sleep (P < 0.001, CI: 2.395-7.640), fatigue (P = 0.038, CI: 0.091-3.258), and depression (P < 0.001, CI: 3.686-7.896). However, there was no significant difference in the incidence of pelvic floor dysfunction between the two groups (OR = 0.719, 95% CI: 0.308-1.681, P = 0.446).
Our study found that a nurse-led mHealth application lifestyle intervention is effective in preventing postpartum constipation and prolonged lochia, as well as improving postpartum depression, fatigue, and sleep quality. This suggests that combining nursing with digital health technologies in clinical work may improve accessibility and continuity of care. Clinicians can enhance the use of mHealth in their work by providing mHealth education to mothers to compensate for the lack of traditional care in the post-discharge phase. However, due to the limitations of this single-center study with a small sample size, future multicenter studies with long-term follow-up are needed to further explore the broader applicability and sustainability of this intervention.
The protocol of the study was registered at ClinicalTrials.gov (ChiCTR2300077685) on November 16, 2023.
产后恶露不绝、便秘、疲劳和抑郁等产后症状的发生率仍然很高。在临床实践中提供产后生活方式干预，包括饮食和运动指导，具有挑战性。通过饮食指导、运动指导和健康教育的护士主导应用程序是一种很有前景的生活方式干预方法。
本随机对照试验评估了2024年1月至11月通过应用程序进行生活方式干预对产后妇女的影响。从中国一家三级医院招募年龄在18-45岁、单胎妊娠无并发症或合并症、能够理解和使用智能手机及移动应用程序等基本技术的产后妇女。总共150名参与者被随机分配（1:1）到干预组（n = 75）或对照组（n = 75）。由于基于应用程序的干预性质，参与者和研究人员无法设盲。在产后42天通过检查电子病历系统或电子问卷收集产后便秘、恶露不绝、盆底肌肉功能障碍、睡眠、疲劳和抑郁的发生情况。
实验组和对照组参与者在基线时具有可比性。在总共150名参与者中，随机分组后，61名（81.3%）和63名（84%）在产后42天成功完成本研究。干预组参与者产后便秘（OR = 0.180，95%CI：0.038-0.857，P = 0.030）和恶露不绝（OR = 0.220，95%CI：0.059-0.823，P = 0.025）的发生率较低。与对照组相比，干预组参与者在睡眠（P < 0.001，CI：2.395-7.640）、疲劳（P = 0.038，CI：0.091-3.258）和抑郁（P < 0.001，CI：3.686-7.896）方面有显著改善。然而，两组间盆底功能障碍的发生率没有显著差异（OR = 0.719，95%CI：0.308-1.681，P = 0.446）。
我们的研究发现，护士主导的移动健康应用程序生活方式干预在预防产后便秘和恶露不绝以及改善产后抑郁、疲劳和睡眠质量方面是有效的。这表明在临床工作中将护理与数字健康技术相结合可能会提高医疗服务的可及性和连续性。临床医生可以通过向母亲提供移动健康教育来加强移动健康在工作中的应用，以弥补出院后阶段传统护理的不足。然而，由于本单中心研究样本量小的局限性，未来需要进行多中心长期随访研究，以进一步探索这种干预措施更广泛的适用性和可持续性。
该研究方案于2023年11月16日在ClinicalTrials.gov（ChiCTR2300077685）注册。
