{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:27Z","timestamp":1785545067635,"version":"3.56.0"},"reference-count":71,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of mobile technologies during high-risk pregnancy, placing patients at the center of care, affords them self-management and easier access to health information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to understand the health perception of pregnant women at the beginning of high-risk antenatal care, the usability of a mobile health app\u2014the Health Assistant\u2014and to compare maternal-fetal outcomes between users and nonusers of the app.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is an observational longitudinal cohort study that looked into clusters of high-risk pregnant women admitted to antenatal care at the maternity unit of a public university hospital in southern Brazil between April 2022 and November 2023. Pregnant women who did not have a compatible smartphone to download the app or who did not have internet access were excluded from the study. According to systematic randomization, one patient was allocated to the app group and the other to the control group. They all answered an inclusion questionnaire (Q1), and those in the app group were instructed to use the Health Assistant app to prepare for their first antenatal appointment, which would take place in a few weeks\u2019 time, when they would answer the Brazilian version of the Mobile App Usability Questionnaire. After childbirth, maternal-fetal outcomes were assessed. Student 2-tailed\n                      <jats:italic>t<\/jats:italic>\n                      test, Mann-Whitney test, Fisher exact test, and the\n                      <jats:sup\/>\n                      chi-square test were used for statistical analysis. A hierarchical cluster analysis was performed using the Ward method and the Euclidean squared distance measure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample contained 111 pregnant women, of whom 55 (49.5%) were allocated to the app group and 56 (50.5%) to the control group. Of the 55 pregnant women who used the app, 21 (38.2%) demonstrated adherence, with an average Mobile App Usability Questionnaire score of 6.2 (SD 1.0). Clustering included 110 pregnant women, and the dendrogram resulted in three clusters, which show several significant differences in terms of family income, medical history, medication adherence, and lifestyle habits. Cluster 2 had the lowest adherence to the app (\n                      <jats:italic>P<\/jats:italic>\n                      =.08) and attended significantly fewer antenatal appointments (6.9 appointments) as compared with Clusters 1 (10.3) and 3 (9.1;\n                      <jats:italic>P<\/jats:italic>\n                      =.006). Cesarean section was more frequent in Cluster 3 (n=41, 95.3%) as compared with Clusters 1 (n=12, 27.9%) and 2 (n=5, 20.8%),\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cluster analysis, revealing different profiles of pregnant women, allowed us to identify groups that would benefit from personalized approaches and digital interventions to improve self-awareness and gestational outcomes. The Health Assistant app showed good usability in this context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/67680","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T22:42:28Z","timestamp":1755816148000},"page":"e67680-e67680","source":"Crossref","is-referenced-by-count":1,"title":["Mobile Health Adoption in High-Risk Pregnancies Using Cluster Analysis of Biopsychosocial Outcomes: Observational Longitudinal Cohort Study"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7896-1758","authenticated-orcid":false,"given":"Fernanda","family":"Schier de Fraga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6370-1463","authenticated-orcid":false,"given":"Mayara Marenda","family":"Narita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6282-8653","authenticated-orcid":false,"given":"Monique","family":"Schreiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1688-4503","authenticated-orcid":false,"given":"Flavio","family":"Belli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9866-0208","authenticated-orcid":false,"given":"Jaqueline","family":"Leonel Celestino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8466-8782","authenticated-orcid":false,"given":"Karolayne","family":"Braz Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3892-7373","authenticated-orcid":false,"given":"Gabriella","family":"Soecki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6642-5894","authenticated-orcid":false,"given":"Vit\u00f3ria","family":"Bevervanso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9012-3922","authenticated-orcid":false,"given":"Rog\u00e9rio","family":"de Fraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"R1","unstructured":"mHealth: New Horizons for Health through Mobile Technologies: Second Global Survey on eHealth. World Health Organization; 2011."},{"issue":"10","key":"R2","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.7988","article-title":"Mobile health apps in OB-GYN-embedded psychiatric care: commentary","volume":"5","author":"Mehralizade","journal-title":"JMIR Mhealth Uhealth"},{"key":"R3","unstructured":"L\u00edvia Moura P Camargo G . Impacto econ\u00f4mico e social do android no Brasil [Report in Portugese]. Bain & Company; 2020."},{"issue":"2","key":"R4","doi-asserted-by":"publisher","DOI":"10.5935\/1415-2762.20140035","article-title":"Mobile applications developed for the health sector in Brazil: an integrative literature review","volume":"18","author":"Dias","journal-title":"Nurs J Minas Gerais"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1037\/pro0000069","article-title":"Ethical guidelines for mobile app development within health and mental health fields","volume":"47","author":"Jones","journal-title":"Prof Psychol Res Pract"},{"key":"R6","unstructured":"Executive Board. mHealth\u2014use of appropriate digital technologies for public health: report by the director-general. World Health Organization; 2017. 142."},{"issue":"2","key":"R7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056807","article-title":"Effects of mHealth on the psychosocial health of pregnant women and mothers: a systematic review","volume":"12","author":"Sakamoto","journal-title":"BMJ Open"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1097\/AOG.0000000000003646","article-title":"Telehealth interventions to improve obstetric and gynecologic health outcomes: a systematic review","volume":"135","author":"DeNicola","journal-title":"Obstet Gynecol"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","DOI":"10.1186\/s44247-024-00092-x","article-title":"Methods for evaluating the efficacy and effectiveness of direct-to-consumer mobile health apps: a scoping review","volume":"2","author":"Prentice","journal-title":"BMC Digital Health"},{"issue":"10","key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/10718","article-title":"Measuring the quality of mobile apps for the management of pain: systematic search and evaluation using the Mobile App Rating Scale","volume":"6","author":"Salazar","journal-title":"JMIR Mhealth Uhealth"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.26633\/RPSP.2022.37","article-title":"Mobile technologies in healthcare: reflections on development, application, legal aspects, and ethics","author":"Marengo","journal-title":"Pan Am J Public Health"},{"issue":"3","key":"R12","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1590\/2237-6089-2015-0067","article-title":"Particularidades da gravidez de alto risco como fatores para o desenvolvimento de sofrimento mental [Article in Portugese]","volume":"38","author":"Rodrigues","journal-title":"Trends Psychiatry Psychother"},{"issue":"2","key":"R13","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1080\/02646830220134612","article-title":"High-risk pregnancies, psychological distress, and dyadic adjustment","volume":"20","author":"Dulude","journal-title":"J Reprod Infant Psychol"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03190-6","article-title":"Well-being in high-risk pregnancy: an integrative review","volume":"20","author":"Mirzakhani","journal-title":"BMC Pregnancy Childbirth"},{"key":"R15","unstructured":"Stewart M Burmeister A da RS Lopes JMC . Patient-Centered Medicine: Transforming the Clinical Method. 3rd ed. 2017. ISBN: 9781846195662"},{"issue":"2","key":"R16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170581","article-title":"What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions","volume":"12","author":"Iribarren","journal-title":"PLoS One"},{"issue":"1","key":"R17","first-page":"247","volume":"39","author":"Banjari","journal-title":"Coll Antropol"},{"issue":"3","key":"R18","doi-asserted-by":"publisher","first-page":"2038","DOI":"10.26452\/ijrps.v10i3.1416","article-title":"A comparative approach to cluster maternal data using k-means and k-medoid","volume":"10","author":"Nair","journal-title":"Int J Res Pharm Sci"},{"issue":"3","key":"R19","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1080\/01443610902753713","article-title":"Identifying pregnant women at risk of poor birth outcomes","volume":"29","author":"Gilligan","journal-title":"J Obstet Gynaecol"},{"issue":"4","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/11500","article-title":"The mHealth App Usability Questionnaire (MAUQ): development and validation study","volume":"7","author":"Zhou","journal-title":"JMIR Mhealth Uhealth"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","first-page":"719","DOI":"10.9790\/3021-0204719725","article-title":"An overview on clustering methods","volume":"02","author":"Madhulatha","journal-title":"IOSRJEN"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Dave M Gianey H . Different clustering algorithms for big data analytics: a review. Presented at: 2016 International Conference System Modeling & Advancement in Research Trends (SMART); Nov 25-27, 2016; Moradabad, India. [doi: 10.1109\/SYSMART.2016.7894544]","DOI":"10.1109\/SYSMART.2016.7894544"},{"issue":"3","key":"R23","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s10994-005-5316-9","article-title":"A unified view on clustering binary data","volume":"62","author":"Li","journal-title":"Mach Learn"},{"issue":"12","key":"R24","doi-asserted-by":"publisher","DOI":"10.14569\/IJACSA.2020.0111218","article-title":"Applications of clustering techniques in data mining: a comparative study","volume":"11","author":"Faizan","journal-title":"IJACSA"},{"key":"R25","unstructured":"Ferreira RRM GSi R Castro GSA . Ana\u0301lise de cluster na\u0303o supervisionado em r: agrupamento hiera\u0301rquico [Web page in Portugese]. EMBRAPA. 2020. URL: https:\/\/www.embrapa.br\/busca-de-publicacoes\/-\/publicacao\/1126478\/analise-de-cluster-nao-supervisionado-em-r-agrupamento-hierarquico [Accessed 08-08-2025]"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.1186\/s12859-022-04675-1","article-title":"Statistical power for cluster analysis","volume":"23","author":"Dalmaijer","journal-title":"BMC Bioinformatics"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.33015\/dominican.edu\/2020.NURS.ST.18","article-title":"Neonatal health outcomes and access to care","author":"DesJarlais","journal-title":"Nursing Senior Theses"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/j.pec.2015.11.006","article-title":"Mobile application as a prenatal education and engagement tool: a randomized controlled pilot","volume":"99","author":"Ledford","journal-title":"Patient Educ Couns"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","DOI":"10.2196\/26159","article-title":"Participants\u2019 engagement and satisfaction with a smartphone app intended to support healthy weight gain, diet, and physical activity during pregnancy: qualitative study within the healthymoms trial","volume":"9","author":"Sandborg","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R30","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13590-2","article-title":"Optimising mothers\u2019 health behaviour after hypertensive disorders of pregnancy: a qualitative study of a postnatal intervention","volume":"22","author":"Rossiter","journal-title":"BMC Public Health"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_1429_21","article-title":"Functionality of self-care for pregnancy mobile applications: a review study","volume":"11","author":"Pouriayevali","journal-title":"J Educ Health Promot"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"30","DOI":"10.11124\/JBISRIR-D-19-00191","article-title":"Impact of mobile health interventions during the perinatal period on maternal psychosocial outcomes: a systematic review","volume":"18","author":"Dol","journal-title":"JBI Evid Synth"},{"issue":"6","key":"R33","doi-asserted-by":"publisher","first-page":"181","DOI":"10.20525\/ijrbs.v8i6.522","article-title":"Understanding the insight of factors affecting mHealth adoption","volume":"8","author":"Kaium","journal-title":"IJRBS"},{"issue":"5","key":"R34","doi-asserted-by":"publisher","DOI":"10.2196\/17572","article-title":"Influences on the uptake of and engagement with health and well-being smartphone apps: systematic review","volume":"22","author":"Szinay","journal-title":"J Med Internet Res"},{"issue":"4","key":"R35","doi-asserted-by":"publisher","DOI":"10.1590\/s0034-759020210403x","article-title":"An analysis of determinants of the adoption of mobile health (mHealth)","volume":"61","author":"Martins","journal-title":"Rev Adm Empres"},{"issue":"5","key":"R36","doi-asserted-by":"publisher","DOI":"10.2196\/35371","article-title":"Factors influencing adherence to mHealth apps for prevention or management of noncommunicable diseases: systematic review","volume":"24","author":"Jakob","journal-title":"J Med Internet Res"},{"issue":"9","key":"R37","doi-asserted-by":"publisher","DOI":"10.2196\/27021","article-title":"Toward a better understanding of the intention to use mHealth apps: exploratory study","volume":"9","author":"Palos-Sanchez","journal-title":"JMIR Mhealth Uhealth"},{"issue":"3","key":"R38","doi-asserted-by":"publisher","first-page":"357","DOI":"10.3390\/healthcare9030357","article-title":"Influencing factors of acceptance and use behavior of mobile health application users: systematic review","volume":"9","author":"Wang","journal-title":"Healthcare (Basel)"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.1177\/1460458220976737","article-title":"Proposing a mobile apps acceptance model for users in the health area: a systematic literature review and meta-analysis","volume":"27","author":"Binyamin","journal-title":"Health Inf J"},{"issue":"1","key":"R40","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-05045-8","article-title":"An examination of the association between marital status and prenatal mental disorders using linked health administrative data","volume":"22","author":"Bedaso","journal-title":"BMC Pregnancy Childbirth"},{"issue":"Suppl 4","key":"R41","first-page":"568","volume":"32","author":"\u00c7elik","journal-title":"Psychiatr Danub"},{"issue":"2","key":"R42","doi-asserted-by":"publisher","first-page":"168","DOI":"10.4103\/ijnmr.IJNMR_32_20","article-title":"Perceived risk in women with high risk pregnancy: a qualitative study","volume":"26","author":"Shojaeian","journal-title":"Iran J Nurs Midwifery Res"},{"issue":"4","key":"R43","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.11591\/ijphs.v12i4.22930","article-title":"Usability assessment using m-Health app usability questionnaire on the iPosyandu application in Central Sulawesi","volume":"12","author":"Abdullah","journal-title":"IJPHS"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurox.2023.100248","article-title":"How does high socioeconomic status affect maternal and neonatal pregnancy outcomes? A population-based study among American women","volume":"20","author":"Nicholls-Dempsey","journal-title":"Eur J Obstet Gynecol Reprod Biol X"},{"issue":"2","key":"R45","doi-asserted-by":"publisher","first-page":"73","DOI":"10.4258\/hir.2016.22.2.73","article-title":"Utilization and content evaluation of mobile applications for pregnancy, birth, and child care","volume":"22","author":"Lee","journal-title":"Healthc Inform Res"},{"issue":"4","key":"R46","doi-asserted-by":"publisher","DOI":"10.2196\/35554","article-title":"Effectiveness of digital interventions for preventing alcohol consumption in pregnancy: systematic review and meta-analysis","volume":"24","author":"Oh","journal-title":"J Med Internet Res"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-021-03684-x","article-title":"Explaining the impact of mHealth on maternal and child health care in low- and middle-income countries: a realist synthesis","volume":"21","author":"Kabongo","journal-title":"BMC Pregnancy Childbirth"},{"key":"R48","unstructured":"Lei n.o 14663, de 29 de setembro de [Web page in Portugese]. Presid\u00eancia da Rep\u00fablica. 2023. URL: https:\/\/www.planalto.gov.br\/CCIVIL_03\/_Ato2023-2026\/2023\/Lei\/L14663.htm [Accessed 08-08-2025]"},{"key":"R49","unstructured":"Lei n.o 14358, de 1o de junho de [Web page in Portugese]. Presid\u00eancia da Rep\u00fablica. 2022. URL: https:\/\/www.planalto.gov.br\/ccivil_03\/_ato2019-2022\/2022\/lei\/l14358.htm [Accessed 08-08-2025]"},{"issue":"7","key":"R50","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10071287","article-title":"Technology-based (Mhealth) and standard\/traditional maternal care for pregnant woman: a systematic literature review","volume":"10","author":"Kusyanti","journal-title":"Healthcare (Basel)"},{"issue":"1","key":"R51","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.midw.2010.10.013","article-title":"The relationship between prenatal control, expectations, experienced control, and birth satisfaction among primiparous women","volume":"28","author":"Fair","journal-title":"Midwifery"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","DOI":"10.1038\/s44294-024-00018-y","article-title":"Sense of self in first-time pregnancy","volume":"2","author":"Perrykkad","journal-title":"NPJ Womens Health"},{"issue":"1","key":"R53","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1111\/ijcp.12582","article-title":"Does mHealth increase adherence to medication? Results of a systematic review","volume":"69","author":"Anglada-Martinez","journal-title":"Int J Clin Pract"},{"issue":"4","key":"R54","doi-asserted-by":"publisher","first-page":"550","DOI":"10.18553\/jmcp.2020.26.4.550","article-title":"Effectiveness of mobile applications on medication adherence in adults with chronic diseases: a systematic review and meta-analysis","volume":"26","author":"Peng","journal-title":"J Manag Care Spec Pharm"},{"issue":"5","key":"R55","doi-asserted-by":"publisher","first-page":"1980","DOI":"10.4103\/jfmpc.jfmpc_1855_21","article-title":"Profile of comorbidity and multimorbidity among women attending antenatal clinics: an exploratory cross-sectional study from Odisha, India","volume":"11","author":"Pati","journal-title":"J Family Med Prim Care"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2023.1151362","article-title":"Disparities in high risk prenatal care adherence along racial and ethnic lines","volume":"4","author":"Stegman","journal-title":"Front Glob Womens Health"},{"issue":"9","key":"R57","doi-asserted-by":"publisher","DOI":"10.2196\/13608","article-title":"Mobile apps for medication management: review and analysis","volume":"7","author":"Tabi","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R58","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1002\/pds.5320","article-title":"Use of a mobile app to capture supplemental health information during pregnancy: implications for clinical research","volume":"31","author":"Rothschild","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"R59","unstructured":"WHO Recommendations on Maternal Health: Guidelines Approved by the WHO Guidelines Review Committee. 2nd ed. World Health Organization; 2023:978-992."},{"key":"R60","unstructured":"Office of the Surgeon General (OSG). The Surgeon General\u2019s Call to Action to Improve Maternal Health. US Department of Health and Human Services; 2020. [Medline: 33661589]"},{"issue":"13","key":"R61","doi-asserted-by":"publisher","first-page":"2195","DOI":"10.1111\/1471-0528.17267","article-title":"An mHealth-supported antenatal lifestyle intervention may be associated with improved maternal sleep in pregnancy: secondary analysis from the PEARS trial","volume":"129","author":"Bartels","journal-title":"BJOG"},{"issue":"4","key":"R62","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1363\/3919407","article-title":"Pregnancy intentions and happiness among pregnant black women at high risk for adverse infant health outcomes","volume":"39","author":"Blake","journal-title":"Perspect Sex Reprod Health"},{"key":"R63","unstructured":"WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organization; 2016. ISBN: 9789241549912"},{"issue":"2","key":"R64","doi-asserted-by":"publisher","first-page":"2393","DOI":"10.36557\/2674-8169.2024v6n2p2393-2408","article-title":"Manejo da gravidez de risco e assist\u00eancia ao pr\u00e9-natal [Article in Portugese]","volume":"6","author":"Ditzel","journal-title":"Braz J Implantol Health Sci"},{"issue":"19","key":"R65","doi-asserted-by":"publisher","first-page":"2635","DOI":"10.3390\/healthcare11192635","article-title":"Effectiveness of mHealth interventions for monitoring antenatal care among pregnant women in low- and middle-income countries: a systematic review and meta-analysis","volume":"11","author":"Mishra","journal-title":"Healthcare (Basel)"},{"issue":"2","key":"R66","doi-asserted-by":"publisher","first-page":"084","DOI":"10.1055\/s-0040-1718446","article-title":"Gestational risk as a determining factor for cesarean section according to the robson classification groups","volume":"43","author":"Soares","journal-title":"Rev Bras Ginecol Obstet"},{"key":"R67","doi-asserted-by":"publisher","DOI":"10.1590\/s1980-220x2018042603526","article-title":"Relationship between gestational risk and type of delivery in high risk pregnancy","volume":"54","author":"Antunes","journal-title":"Rev Esc Enferm USP"},{"issue":"5","key":"R68","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194337","article-title":"The health-e Babies app for antenatal education: feasibility for socially disadvantaged women","volume":"13","author":"Dalton","journal-title":"PLOS One"},{"issue":"6","key":"R69","doi-asserted-by":"publisher","DOI":"10.2196\/12631","article-title":"Understanding the use of smartphone apps for health information among pregnant chinese women: mixed methods study","volume":"7","author":"Wang","journal-title":"JMIR Mhealth Uhealth"},{"key":"R70","unstructured":"Global Diffusion of Ehealth: Making Universal Health Coverage Achievable: Report of the Third Global Survey on Ehealth. World Health Organization; 2016. ISBN: 978-92-4-151178-0"},{"issue":"4","key":"R71","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.8834","article-title":"The usability and effectiveness of mobile health technology-based lifestyle and medical intervention apps supporting health care during pregnancy: systematic review","volume":"6","author":"Overdijkink","journal-title":"JMIR Mhealth Uhealth"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/humanfactors.jmir.org\/2025\/1\/e67680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:27:46Z","timestamp":1785536866000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2025\/1\/e67680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":71,"URL":"https:\/\/doi.org\/10.2196\/67680","relation":{},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,21]]},"article-number":"v12i10e67680"}}