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To address these challenges and optimize hemoglobin (Hb) levels among pregnant women, mobile health (mHealth)\u2212based nutritional interventions offer a promising alternative.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of the study is to review available evidence on the effectiveness of mHealth-based nutritional interventions on iron status (Hb and\/or serum ferritin concentration) among pregnant women.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Searches were conducted in Embase, CINAHL, Cochrane Library, PubMed, Web of Science, and Scopus, and supplemented by snowballing to identify additional relevant studies from citation lists. The key search strings comprised 4 concepts: \u201cmobile health,\u201d \u201cnutritional intervention,\u201d \u201cHb, anemia or iron deficiency anemia,\u201d and \u201cpregnant women.\u201d Predefined inclusion and exclusion criteria were applied during screening. The methodological quality of included studies was assessed using the Risk of Bias 2 tool. The primary end point was the change in mean Hb concentration or serum ferritin level. Effect sizes (ESs) were calculated as standardized mean differences, including Cohen\n d<\/jats:italic>\n and Hedges\n g<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 14,284 studies identified, only 11 randomized controlled trials were included. These studies used various modes of delivery, including mobile phone calls (n=1), SMS text messaging (n=3), and mobile apps (n=4), with some using more than 2 modes (n=3). The effect of mHealth-based nutritional interventions on iron status varied significantly. In total, 4 studies demonstrated a large ES (>0.8), with 3 relying on WhatsApp Messenger as an mHealth delivery mode. Approximately 82% (9\/11) of the included studies reported a positive effect (\n P<\/jats:italic>\n values ranging from <.001 to .047) of the intervention on Hb level, whereas 2 studies reported no statistically significant association (\n P<\/jats:italic>\n =.33 and\n P<\/jats:italic>\n =.35, respectively). Notably, interventions with the largest ES achieved clinically significant improvements in Hb concentration, with within- and between-group differences exceeding 1 g\/dL. However, including behavioral change theories and nutrition-sensitive components was not consistently associated with larger ESs. Due to high heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n >95%), attributed to variations in mHealth delivery modes, functions, and interactive features across the included studies, meta-analysis could not be performed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This review demonstrates that mHealth-supported nutritional interventions effectively optimize Hb concentration in pregnant women. While SMS text messaging was less effective in improving Hb concentration, combining it with another mHealth delivery mode, such as phone calls, improved intervention effectiveness. However, the variability in mHealth delivery modes, functions, and interactive features underscores the need for tailored strategies that account for context-specific challenges, digital literacy, and access to technology to enhance effectiveness.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/81001","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:35:08Z","timestamp":1771353308000},"page":"e81001-e81001","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of mHealth-Based Nutritional Interventions on Iron Status of Pregnant Women: Systematic Review of Randomized Controlled Trials"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9681-0854","authenticated-orcid":false,"given":"Saba Abraham","family":"Belay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0707-4363","authenticated-orcid":false,"given":"Afework Mulugeta","family":"Bezabih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4553-4407","authenticated-orcid":false,"given":"Wim Van","family":"Petegem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1770-6862","authenticated-orcid":false,"given":"Christophe","family":"Matthys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"R1","unstructured":"Haemoglobin concentration for the diagnosis of anemia and assessment of severity. 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