Background: Gestational diabetes mellitus (GDM) can usually be well controlled by health education and lifestyle management, resulting in better pregnancy outcomes. However, standard clinical prenatal care, which consists of clinic visits every 2 weeks, may not provide sufficient management for women with GDM. Telemedicine demonstrates a potential to fill this gap. Objective: The objective of this study was to investigate whether health education and lifestyle management delivered through a WeChat group chat was more effective in controlling blood glucose (BG) than standard clinical prenatal care among women with GDM. Methods: In this multicenter randomized controlled trial, women with GDM diagnosed by an oral glucose tolerance test between 23 and 30 (+6) gestational weeks were randomized to a WeChat group chat–based BG management group or a routine clinical prenatal care group. The primary outcome was the change in the glycemic qualification rate during the follow-up period in both groups. The secondary outcomes were pregnancy outcomes. Results: A total of 309 women with GDM participated in the trial, with 162 women randomized to the control group and 147 to the intervention group. No significant differences in baseline characteristics were found between the control and intervention groups. Participants were further divided into 4 groups according to gestational weeks at enrollment for further analysis. The glycemic qualification rate of the intervention group was higher than that of the control group at nearly all time points in Groups 1 to 3, among which 3 time points reached statistical significance: Group 1 at T3 (54.8% vs 83.3%) and Group 2 at T3 (62.5% vs 80.0%) and T7 (75.0% vs 100%). The glycemic qualification rate gradually increased as gestational weeks progressed in both groups, regardless of the intervention method. None of the pregnancy outcomes measured, including delivery mode, premature rupture of the membranes, preterm birth, infant's birth weight, and postpartum hemorrhage, were significantly different between the control and intervention groups. Conclusions: This multicenter randomized controlled trial that assessed women with noninsulin-dependent GDM demonstrated that additional instant messaging platforms, such as WeChat, used for health education and lifestyle intervention in China tend to be more effective for BG control than standard clinical prenatal care alone. Trial Registration: ClinicalTrials.gov NCT03748576; https://clinicaltrials.gov/ct2/show/NCT03748576

Background: Pregnancy is a pivotal phase in a woman’s life, demanding special attention to ensure maternal and fetal health. Prenatal education plays a vital role in promoting healthy pregnancies and reducing adverse outcomes for pregnant women. Mobile prenatal education programs have gained traction due to their accessibility and timeliness, especially in light of finite health care resources and the constraints imposed by the COVID-19 pandemic. Objective: This study aims to develop and evaluate the effectiveness of a mobile-based prenatal education program in improving pregnancy outcomes. Methods: We developed a mobile-based prenatal education curriculum in collaboration with a multidisciplinary maternal care team from Peking Union Medical College Hospital (PUMCH) in Beijing, China. Data were retrospectively collected from 1941 pregnant women who had registered for the PUMCH mobile prenatal education program and subsequently delivered at PUMCH between May 2021 and August 2022. The study compared pregnancy outcomes between the completing group, which were pregnant women who had completed at least 1 course, and the noncompleting group. We also analyzed differences among course topics within the completing group and assessed course topic popularity among pregnant women. Results: The PUMCH mobile prenatal education curriculum consists of 436 courses across 9 topics. Out of the participants, a total of 1521 did not complete any courses, while 420 completed at least 1 course. Compared with the noncompleting group, pregnant women who completed courses exhibited a significant reduction in the risk of gestational diabetes mellitus, induced abortion, postpartum infection, fetal intrauterine distress, and neonatal malformation. Among those in the completing group, a total of 86% (361/420) started course completion during the first and second trimesters. Furthermore, completing courses related to topics of pregnancy psychology and pregnancy nutrition was associated with reduced risks of premature rupture of membranes and small for gestational age infants, respectively. Pregnancy psychology and postpartum recovery were the preferred topics among pregnant women. Conclusions: The study demonstrates the potential of mobile-based prenatal education programs in improving pregnancy outcomes and supporting health care providers in delivering effective prenatal education. The rise of mobile prenatal education presents an opportunity to improve maternal and child health outcomes. Further research and broader implementation of such programs are warranted to continually improve maternal and child health.

Objective: Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications. Electronic health records (EHRs) promise GDM risk prediction, but missing data poses a challenge to developing reliable and generalizable risk prediction models. This study aims to address the problem of missing EHR data in GDM prediction before 12 weeks gestation. Methods: A total of 5066 women with singleton pregnancies, aged 18 to 50, were included in this retrospective study. This study evaluated 6 imputation methods, combined with 4 classification machine learning models. The evaluation encompassed downstream predictive performance, robustness to variable missingness, ability to restore original data distribution, and influence on feature selection based on 10-fold cross-validation. Results: Our findings revealed a significant improvement in model performance with imputation. When using the top 30 features, logistic regression (LR) with multivariate imputation by chained equations using classification and regression trees (mice) achieved the highest area under the receiver operating characteristic curve of 0.6899, compared to 0.6336 for the LR model without imputation. Mice also led to the best average performance across prediction models and yielded the most accurate restoration of the original data distribution. LR models trained on data imputed by mice remained the most robust across varying levels of missingness. The classification algorithm primarily accounted for differences in predictive performance. In addition, we identified 18 key features for early GDM prediction in the Chinese population. Conclusion: This study demonstrates the critical role of imputation in improving the performance and fairness of GDM prediction models. The findings provide practical guidance for integrating imputation into clinical machine learning pipelines.

Background: Maternal health during the perinatal period is a global public health priority. While antenatal education is widely implemented, conventional lecture-based models often fail to achieve sustained behavior change. Innovative approaches that integrate experiential learning with digital support may enhance maternal knowledge, self-management, and pregnancy outcomes. Objective: The aim of this study is to evaluate the feasibility and preliminary effectiveness of a combined experiential class and online logging intervention for pregnant women in China and to explore the mechanisms underpinning its impact on health practices and service experiences. Methods: A mixed methods design was used in a district-level maternal and child health hospital in Beijing. In the quantitative arm, 40 women (intervention group, n=20; control group, n=20) were enrolled in a quasi-experimental comparison. Outcomes included knowledge-attitude-practice indicators, service satisfaction, and clinical birth outcomes. Given the limited sample size, a qualitative arm was conducted to complement statistical findings: semistructured interviews with 20 women (10 per group) were analyzed thematically. Quantitative and qualitative results were integrated during interpretation to provide a comprehensive evaluation. Results: Compared with the experiential class alone, the combined intervention was associated with higher knowledge scores (mean difference 1.6 points, 95% CI 0.8-2.4), stronger adherence to recommended health practices (composite adherence score difference 1.0, 95% CI 0.4-1.6), and higher overall service satisfaction (mean difference 0.6, 95% CI 0.2-1.0). Across multiple domains, a higher proportion of participants in the intervention group met dietary, exercise, and supplementation recommendations. Clinical outcome differences were exploratory, as the study was not powered for these end points. Qualitative analysis revealed 3 mechanisms, such as empowerment and self-efficacy, practice and persistence, and systemic/environmental support, through which the intervention influenced experiences and practices. Conclusions: The experiential class plus online logging model is feasible and acceptable in a real-world antenatal setting. Although limited by a small sample size, findings suggest that the intervention improves maternal knowledge, health practices, and service experiences and may inform future adequately powered trials to evaluate pregnancy outcomes. Qualitative insights highlight mechanisms of health practice change and provide contextual depth, underscoring the value of mixed methods designs in maternal health research.

UNSTRUCTURED In the integrated management of gestational diabetes mellitus (GDM), health education plays an important role and directly affects patients’ blood glucose level control, pregnancy, and neonatal outcome. The rapid growth of the Internet has ushered in an era of big data and the rational use of the Internet. We developed an innovative mobile application (app) combining a teaching model of the flipped classroom and GDM management, which allows pregnant women to learn about and help prevent GDM. This app can overcome the treatment barriers for those patients that cannot go to the hospital, enhance health promotion efforts, and improve GDM management.

BACKGROUND Pregnancy is a pivotal phase in a woman’s life, demanding special attention to ensure maternal and fetal health. Prenatal education plays a vital role in promoting healthy pregnancies and reducing adverse outcomes for pregnant women. Mobile prenatal education programs have gained traction due to their accessibility and timeliness, especially in light of finite health care resources and the constraints imposed by the COVID-19 pandemic. OBJECTIVE This study aims to develop and evaluate the effectiveness of a mobile-based prenatal education program in improving pregnancy outcomes. METHODS We developed a mobile-based prenatal education curriculum in collaboration with a multidisciplinary maternal care team from Peking Union Medical College Hospital (PUMCH) in Beijing, China. Data were retrospectively collected from 1941 pregnant women who had registered for the PUMCH mobile prenatal education program and subsequently delivered at PUMCH between May 2021 and August 2022. The study compared pregnancy outcomes between the completing group, which were pregnant women who had completed at least 1 course, and the noncompleting group. We also analyzed differences among course topics within the completing group and assessed course topic popularity among pregnant women. RESULTS The PUMCH mobile prenatal education curriculum consists of 436 courses across 9 topics. Out of the participants, a total of 1521 did not complete any courses, while 420 completed at least 1 course. Compared with the noncompleting group, pregnant women who completed courses exhibited a significant reduction in the risk of gestational diabetes mellitus, induced abortion, postpartum infection, fetal intrauterine distress, and neonatal malformation. Among those in the completing group, a total of 86% (361/420) started course completion during the first and second trimesters. Furthermore, completing courses related to topics of pregnancy psychology and pregnancy nutrition was associated with reduced risks of premature rupture of membranes and small for gestational age infants, respectively. Pregnancy psychology and postpartum recovery were the preferred topics among pregnant women. CONCLUSIONS The study demonstrates the potential of mobile-based prenatal education programs in improving pregnancy outcomes and supporting health care providers in delivering effective prenatal education. The rise of mobile prenatal education presents an opportunity to improve maternal and child health outcomes. Further research and broader implementation of such programs are warranted to continually improve maternal and child health.