{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:16:02Z","timestamp":1793333762516,"version":"4.5.0"},"reference-count":46,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Danish Life Science Cluster"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,5]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Excessive gestational weight gain increases the risk of complications in pregnancy, childbirth and later in life among pregnant women living with overweight and their offspring. Therefore, this study aimed to develop and examine the feasibility of a digital intervention supporting recommended gestational weight gain and the recommended level of physical activity, targeting pregnant women with a body mass index (BMI) of 27 or above.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Intervention development was guided by the Medical Research Council guideline on the development and evaluation of complex interventions, and subsequent feasibility testing was conducted in a non-randomised design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The obstetric department at Copenhagen University Hospital\u2014North Zealand, Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>98 pregnant women living with overweight participated in feasibility testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>The intervention developed in this study was a mobile phone application with a digital care guide containing text and video information supporting recommended gestational weight gain and physical activity levels. The video material featured multiple healthcare professionals and a pregnant woman from the target group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The main feasibility measures were participant recruitment and engagement with the digital care guide throughout pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recruitment rates were satisfactory, with 69% of eligible pregnant women consenting to participation. The participants used the application and engaged with the digital care guide; however, use of the care guide diminished as pregnancy progressed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We developed a digital care guide supporting recommended gestational weight gain and physical activity levels for pregnant women with a BMI of 27 or higher. Feasibility testing indicated that there is sufficient interest in participating in a study promoting recommended weight gain and physical activity to warrant a larger effectiveness trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112204","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:25:36Z","timestamp":1778682336000},"page":"e112204","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["HealthyPregnancy: development and feasibility of a digital care guide to promote recommended gestational weight gain in pregnant women living with overweight in Denmark"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5393-1552","authenticated-orcid":false,"given":"Mette Kabell","family":"Hansen","sequence":"first","affiliation":[{"name":"Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Marie","family":"Bendix","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-5663","authenticated-orcid":false,"given":"Ellen Christine Leth","family":"L\u00f8kkegaard","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Nordsjaellands Hospital, Hillerod, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2575-6686","authenticated-orcid":false,"given":"Michaela Louise","family":"Schi\u00f8tz","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark"},{"name":"Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Region Syddanmark, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1778-7941","authenticated-orcid":false,"given":"Lotte","family":"Broberg","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, Frederiksberg, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark"},{"name":"Department of Gynecology and Obstetrics, Slagelse Hospital, Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"2026051307252253000_16.5.e112204.1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004395"},{"key":"2026051307252253000_16.5.e112204.2","unstructured":"Anbefalinger for Svangreomsorgen. 4. Udgave. udgave. Danish Health Authority, 2022."},{"key":"2026051307252253000_16.5.e112204.3","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12288"},{"key":"2026051307252253000_16.5.e112204.4","doi-asserted-by":"crossref","unstructured":"Fakhraei R , Denize K , Simon A , et al . Predictors of adverse pregnancy outcomes in pregnant women living with obesity: a systematic review. Int J Environ Res Public Health 2022;19. doi:10.3390\/ijerph19042063","DOI":"10.3390\/ijerph19042063"},{"key":"2026051307252253000_16.5.e112204.5","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/ajcn\/86.2.404","article-title":"High prepregnant body mass index is associated with early termination of full and any breastfeeding in Danish women","volume":"86","author":"Baker","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"2026051307252253000_16.5.e112204.6","doi-asserted-by":"crossref","first-page":"2657","DOI":"10.1080\/14767058.2018.1443440","article-title":"The association between birth weight at term and long-term endocrine morbidity of the offspring","volume":"32","author":"Spiegel","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2026051307252253000_16.5.e112204.7","doi-asserted-by":"crossref","unstructured":"Mahmoud A , Sandblad KG , Lundberg CE , et al . Prepregnancy overweight and obesity and long-term risk of venous thromboembolism in women. Sci Rep 2023;13. doi:10.1038\/s41598-023-41186-2","DOI":"10.1038\/s41598-023-41186-2"},{"key":"2026051307252253000_16.5.e112204.8","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1001\/jamainternmed.2021.6373","article-title":"Association of antenatal diet and physical activity-based interventions with gestational weight gain and pregnancy outcomes: a systematic review and meta-analysis","volume":"182","author":"Teede","year":"2022","journal-title":"JAMA Intern Med"},{"key":"2026051307252253000_16.5.e112204.9","doi-asserted-by":"crossref","unstructured":"Dzakpasu S , Fahey J , Kirby RS , et al . Contribution of prepregnancy body mass index and gestational weight gain to adverse neonatal outcomes: population attributable fractions for Canada. BMC Pregnancy Childbirth 2015;15. doi:10.1186\/s12884-015-0452-0","DOI":"10.1186\/s12884-015-0452-0"},{"key":"2026051307252253000_16.5.e112204.10","doi-asserted-by":"crossref","unstructured":"Al Mamun A , Mannan M , O\u2019Callaghan MJ , et al . Association between gestational weight gain and postpartum diabetes: evidence from a community based large cohort study. PLoS One 2013;8. doi:10.1371\/journal.pone.0075679","DOI":"10.1371\/journal.pone.0075679"},{"key":"2026051307252253000_16.5.e112204.11","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1016\/S0140-6736(23)01517-9","article-title":"Gestational weight change in a diverse pregnancy cohort and mortality over 50 years: a prospective observational cohort study","volume":"402","author":"Hinkle","year":"2023","journal-title":"The Lancet"},{"key":"2026051307252253000_16.5.e112204.12","doi-asserted-by":"crossref","first-page":"101247","DOI":"10.1016\/j.ajogmf.2023.101247","article-title":"Severity of excessive gestational weight gain and risk of severe maternal morbidity","volume":"6","author":"Kouba","year":"2024","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2026051307252253000_16.5.e112204.13","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15661"},{"key":"2026051307252253000_16.5.e112204.14","doi-asserted-by":"crossref","unstructured":"Moll U , Olsson H , Landin-Olsson M . Impact of pregestational weight and weight gain during pregnancy on long-term risk for diseases. PLoS One 2017;12. doi:10.1371\/journal.pone.0168543","DOI":"10.1371\/journal.pone.0168543"},{"key":"2026051307252253000_16.5.e112204.15","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000739"},{"key":"2026051307252253000_16.5.e112204.16","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.ajog.2008.09.879","article-title":"Gestational weight gain by body mass index among US women delivering live births, 2004-2005: fueling future obesity","volume":"200","author":"Chu","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"2026051307252253000_16.5.e112204.17","doi-asserted-by":"crossref","unstructured":"Broberg L , Ersb\u00f8ll AS , Backhausen MG , et al . Compliance with national recommendations for exercise during early pregnancy in a Danish cohort. BMC Pregnancy Childbirth 2015;15. doi:10.1186\/s12884-015-0756-0","DOI":"10.1186\/s12884-015-0756-0"},{"key":"2026051307252253000_16.5.e112204.18","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/birt.12396","article-title":"Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: a meta-analysis","volume":"46","author":"Du","year":"2019","journal-title":"Birth"},{"key":"2026051307252253000_16.5.e112204.19","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12691"},{"key":"2026051307252253000_16.5.e112204.20","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.ajog.2013.09.029","article-title":"The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women","volume":"210","author":"Renault","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2026051307252253000_16.5.e112204.21","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1150"},{"key":"2026051307252253000_16.5.e112204.22","doi-asserted-by":"crossref","unstructured":"Flores Mateo G , Granado-Font E , Ferr\u00e9-Grau C , et al . Mobile phone apps to promote weight loss and increase physical activity: a systematic review and meta-analysis. J Med Internet Res 2015;17. doi:10.2196\/jmir.4836","DOI":"10.2196\/jmir.4836"},{"key":"2026051307252253000_16.5.e112204.23","doi-asserted-by":"crossref","unstructured":"Schoeppe S , Alley S , Van Lippevelde W , et al . Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2016;13. doi:10.1186\/s12966-016-0454-y","DOI":"10.1186\/s12966-016-0454-y"},{"key":"2026051307252253000_16.5.e112204.24","doi-asserted-by":"crossref","unstructured":"Raab R , Geyer K , Zagar S , et al . App-supported lifestyle interventions in pregnancy to manage gestational weight gain and prevent gestational diabetes: scoping review. J Med Internet Res 2023;25. doi:10.2196\/48853","DOI":"10.2196\/48853"},{"key":"2026051307252253000_16.5.e112204.25","doi-asserted-by":"crossref","unstructured":"Sandborg J , S\u00f6derstr\u00f6m E , Henriksson P , et al . Effectiveness of a smartphone app to promote healthy weight gain, diet, and physical activity during pregnancy (HealthyMoms): randomized controlled trial. JMIR Mhealth Uhealth 2021;9. doi:10.2196\/26091","DOI":"10.2196\/26091"},{"key":"2026051307252253000_16.5.e112204.26","unstructured":"Digital Health Strategy 2018\u20132022. Denmark: Ministry of Health, 2018."},{"key":"2026051307252253000_16.5.e112204.27","doi-asserted-by":"crossref","unstructured":"Meldgaard M , Jensen AL , Johansen AD , et al . Health literacy and related behaviour among pregnant women with obesity: a qualitative interpretive description study. BMC Pregnancy Childbirth 2022;22. doi:10.1186\/s12884-022-05023-0","DOI":"10.1186\/s12884-022-05023-0"},{"key":"2026051307252253000_16.5.e112204.28","doi-asserted-by":"crossref","unstructured":"Fjorback SSO , Hugin AW , Schi\u00f8tz ML , et al . Experiences of a digital application intervention supporting recommended weight gain among pregnant women with BMI \u226527 in Denmark - a qualitative study. Midwifery 2025;148. doi:10.1016\/j.midw.2025.104519","DOI":"10.1016\/j.midw.2025.104519"},{"key":"2026051307252253000_16.5.e112204.29","doi-asserted-by":"crossref","unstructured":"Skivington K , Matthews L , Simpson SA , et al . A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ 2021;374. doi:10.1136\/bmj.n2061","DOI":"10.1136\/bmj.n2061"},{"key":"2026051307252253000_16.5.e112204.30","doi-asserted-by":"crossref","unstructured":"O\u2019Cathain A , Croot L , Sworn K , et al . Taxonomy of approaches to developing interventions to improve health: a systematic methods overview. Pilot Feasibility Stud 2019;5. doi:10.1186\/s40814-019-0425-6","DOI":"10.1186\/s40814-019-0425-6"},{"key":"2026051307252253000_16.5.e112204.31","doi-asserted-by":"crossref","unstructured":"Bond C , Lancaster GA , Campbell M , et al . Pilot and feasibility studies: extending the conceptual framework. Pilot Feasibility Stud 2023;9. doi:10.1186\/s40814-023-01233-1","DOI":"10.1186\/s40814-023-01233-1"},{"key":"2026051307252253000_16.5.e112204.32","unstructured":"Stickdorn M , Hormess M , Lawrence A , eds. This Is Service Design Doing: Applying Service Design Thinking in the Real World\u202f; a Practitioners\u2019 Handbook. 10. Nachdr. Sebastopol. Sebastopol, CA: O\u2019Reilly Media, 2021."},{"key":"2026051307252253000_16.5.e112204.33","doi-asserted-by":"crossref","unstructured":"Knudsen S de P , Alomairah SA , Roland CB , et al . Effects of structured supervised exercise training or motivational counseling on pregnant women\u2019s physical activity level: fitmum - randomized controlled trial. J Med Internet Res 2022;24. doi:10.2196\/37699","DOI":"10.2196\/preprints.37699"},{"key":"2026051307252253000_16.5.e112204.34","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-100056"},{"key":"2026051307252253000_16.5.e112204.35","doi-asserted-by":"publisher","DOI":"10.1111\/j..2002.384.doc.x"},{"key":"2026051307252253000_16.5.e112204.36","doi-asserted-by":"crossref","unstructured":"Nikolopoulos H , Mayan M , MacIsaac J , et al . Women\u2019s perceptions of discussions about gestational weight gain with health care providers during pregnancy and postpartum: a qualitative study. BMC Pregnancy Childbirth 2017;17. doi:10.1186\/s12884-017-1257-0","DOI":"10.1186\/s12884-017-1257-0"},{"key":"2026051307252253000_16.5.e112204.37","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/j.1740-8709.2011.00386.x","article-title":"\u201cGet alongside us\u201d, women\u2019s experiences of being overweight and pregnant in Sydney, Australia","volume":"9","author":"Mills","year":"2013","journal-title":"Matern Child Nutr"},{"key":"2026051307252253000_16.5.e112204.38","doi-asserted-by":"crossref","unstructured":"Modde Epstein C , Houfek JF , Jones LP . Deep health: a qualitative, woman-centered perspective of health during pregnancy. Midwifery 2023;120. doi:10.1016\/j.midw.2023.103628","DOI":"10.1016\/j.midw.2023.103628"},{"key":"2026051307252253000_16.5.e112204.39","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.jad.2022.10.026","article-title":"The impact of physical activity intervention on perinatal depression: a systematic review and meta-analysis","volume":"321","author":"He","year":"2023","journal-title":"J Affect Disord"},{"key":"2026051307252253000_16.5.e112204.40","doi-asserted-by":"crossref","unstructured":"Waring ME , Moore Simas TA , Heersping GE , et al . Development and feasibility of a web-based gestational weight gain intervention for women with pre-pregnancy overweight or obesity. Mhealth 2023;9. doi:10.21037\/mhealth-22-49","DOI":"10.21037\/mhealth-22-49"},{"key":"2026051307252253000_16.5.e112204.41","doi-asserted-by":"crossref","unstructured":"Nicholson WK , Beckham AJ , Hatley K , et al . The Gestational Diabetes Management System (GooDMomS): development, feasibility and lessons learned from a patient-informed, web-based pregnancy and postpartum lifestyle intervention. BMC Pregnancy Childbirth 2016;16. doi:10.1186\/s12884-016-1064-z","DOI":"10.1186\/s12884-016-1064-z"},{"key":"2026051307252253000_16.5.e112204.42","doi-asserted-by":"crossref","unstructured":"Rhodes A , Smith AD , Chadwick P , et al . Exclusively digital health interventions targeting diet, physical activity, and weight gain in pregnant women: systematic review and meta-analysis. JMIR Mhealth Uhealth 2020;8. doi:10.2196\/18255","DOI":"10.2196\/preprints.18255"},{"key":"2026051307252253000_16.5.e112204.43","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1111\/obr.12557","article-title":"Electronic-based lifestyle interventions in overweight or obese perinatal women: a systematic review and meta-analysis","volume":"18","author":"Lau","year":"2017","journal-title":"Obes Rev"},{"key":"2026051307252253000_16.5.e112204.44","unstructured":"Ministry of the Interior and Health of Denmark . Bekendtg\u00f8relse af lov om videnskabsetisk behandling af sundhedsvidenskabelige forskningsprojekter og sundhedsdatavidenskabelige forskningsprojekter (the scientific ethical committees act). 2024."},{"key":"2026051307252253000_16.5.e112204.45","doi-asserted-by":"crossref","unstructured":"World Medical Association . World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA Published Online First 2024. doi:10.1001\/jama.2024.21972","DOI":"10.1001\/jama.2024.21972"},{"key":"2026051307252253000_16.5.e112204.46","unstructured":"The Danish Ministry of Justice . Bekendtg\u00f8relse af lov om supplerende bestemmelser til forordning om beskyttelse af fysiske personer i forbindelse med behandling af personoplysninger og om fri udveksling af s\u00e5danne oplysninger (the danish data protection act). 2024."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-112204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T14:26:10Z","timestamp":1778682370000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-112204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":46,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,13]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bmjopen-2025-112204"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-112204","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}