Hans van den Heuvel

conversation with their health care giver on this subject. 19 There is an increasing use of Internet for health information, including the perinatal period. However, websites are often contradictory and this may lead to confusion. 20 E-health may be helpful to address questions through informative websites, apps and peer support platforms designed by health professionals. Furthermore, e-health may provide possibilities for decision support in more complicated pregnancies. 21 Table 1: Information and e-health use in pregnancy: overview of the literature First author, year Methods n = Technology / e-health intervention Sayakhot, 2016 12 Systematic review (with 7 cross sectional studies) 3,359 Patients’ use of internet for pregnancy information Ledford 2016 22 RCT pilot 150 App for pregnancy education and record keeping Walker 2013 15 Prospective cohort 8 Website for education on placental complications Bush 2017 23 Before-after study 85 Prenatal care app use and user engagement Wallwiener 2016 7 Cross sectional 220 Surveys and questionnaires on use of e-health (smartphones, Internet, apps) during pregnancy Scaioli 2015 13 1,347 Peragallo 2015 24 100 Lee 2016 14 193 Lupton 2016 25 410 Narasimhulu 2016 17 586 Goetz 2017 26 Qualitative research total = 128 Focus groups and interviews on e-health use and implementation (in pregnant women, men and clinicians) Willcox 2015 27 Rodger 2013 11 Mackert 2015 28 Lupton 2016 25 Health outcome after e-health intervention The effect on health is the most important issue to address in the effective implementation of e-health in perinatal care. Parameters for quality standards include disease outcomes, enhancing patient adherence to treatment, reducing overuse and increasing access to care. 29 Results of the search showed that most publications focus on the improvement of lifestyle (gestational weight gain, exercise, smoking cessation), gestational diabetes monitoring, mental health, care in lower and middle income countries and telemonitoring. Lifestyle Our search provided 13 publications describing health outcomes for e-health interventions on lifestyleduringpregnancy (Table 2). Pursuing a healthy lifestylehas proven tobe beneficial for pregnancy outcomes such as preterm birth, gestational diabetes or pre-eclampsia. 30-32 Participant motivation, reducing the dropout rate and sustainability of long-term results CHAPTER 2 22