A pragmatic, scalable e-health intervention for management of gestational weight gain in low-income mothers

PROJECT SUMMARY The SARS-CoV-2 (COVID-19) pandemic is adversely impacting the physical and mental health of non- pregnant people, including weight gain and increased sedentary behavior, depression, anxiety, and stress. The overarching goal of this administrative supplement to A pragmatic, scalable e-health intervention for management of gestational weight gain in low-income mothers (R01NR017644), is to expand these observations into pregnant and postpartum populations with the long-term objective of understanding the impact of the COVID-19 pandemic on perinatal physical and mental health outcomes among women who were pregnant during the pandemic and to identify mediators of this impact. The central hypothesis is that exposure to the COVID-19 pandemic during pregnancy will be associated with worsened perinatal physical and mental health outcomes. The specific aims are: 1) examine the effects of the COVID-19 pandemic on gestational weight gain among pregnant women in Louisiana, 2) investigate the effects of the COVID-19 pandemic on racial disparities on adverse pregnancy outcomes among women pregnant during the pandemic in Louisiana, and 3) examine the effects of the COVID-19 pandemic on perinatal mental health among women pregnant during the pandemic in Louisiana. Louisiana is a living laboratory for the country and the world, with an expansive spectrum of income and education levels, and high racial diversity. The specific aims will be tested with two unique study designs. First, a retrospective chart review of deliveries at Woman's Hospital (Baton Rouge, Louisiana) will be used to compare gestational weight gain and pregnancy outcomes from women who were pregnant during the pandemic, compared to women who were pregnant immediately before the pandemic (n=~23,000); as well as comparing outcomes between Black and White women. Second, using a sequential explanatory mixed-methods design we will survey and interview two cohorts of recently postpartum women who were pregnant during the pandemic about their mental health as well as pandemic-related hardships: Louisiana WIC recipients and patients of Woman's Hospital. The mixed-methods design offers rigor by integrating components of triangulation, complementarity, expansion, and development. The project survey includes validated mental health questionnaires and common data elements of the NICHD Promoting Data Harmonization to Accelerate COVID-19 Pregnancy Research. Potential mediators are pandemic-related hardships, including isolation and changes to government assistance, housing, employment, or access to medical care. At the end of the project, our expected outcome is to have quantified the impact of the COVID-19 pandemic on the physical and mental health of pregnant and postpartum women and identified mediators of that impact.