A randomized digital behavioral intervention for prenatal and postpartum weight outcomes in women with overweight or obesity: the GROWell trial

Abstract Background Rising rates of overweight and obesity globally have led to an increasing number of women who enter pregnancy with excess weight, posing significant health risks to mothers and infants. Mobile health interventions, such as smartphone apps, may be a solution to improving pregnancy outcomes, however, limited randomized studies have examined this approach for gestational weight gain (GWG) and postpartum weight retention (PPWR). We report results from a double-blinded, randomized control trial of Goals for Reaching Optimal Wellness ( GROWell ), a mobile app and text-based intervention designed to improve diet quality and associated weight outcomes in pregnant and postpartum women. Methods Women living in California with BMI = 25–42 kg/m 2 and a singleton, uncomplicated pregnancy were recruited via social media or clinic in early pregnancy from January 2021 through March 2023. Aft