The use of mobile health (mHealth) apps during pregnancy is becoming increasingly prevalent, driven by the need for accessible, real-time health interventions. Midwifery-led mHealth interventions are especially well-positioned to address gaps in prenatal care and ensure continuity of care, particularly for underserved populations (Dai et al. 2024; Edwards et al. 2021). These apps allow for self-monitoring, provide educational resources and foster communication between healthcare professionals and pregnant women, all of which can help promote healthier pregnancies and birth outcomes. We read with great interest the recent article by Dai and colleagues entitled ‘Assessing women's and health professionals' views on developing a midwifery-led mobile health app intervention in pregnancy: A descriptive qualitative study’ (Dai et al. 2024), which explored women's and health professionals' views on the development of a midwifery-led mHealth app intervention in antenatal care and their demands for app functionality. We are writing to express my interest and explore the growing role of midwifery-led mHealth interventions, drawing on insights from recent studies to analyse their potential benefits, limitations and challenges.

Midwives are the primary caregivers for many pregnant women, and they are uniquely positioned to provide holistic care that focuses on both physical and emotional well-being (Dai et al. 2024). However, access to midwifery care can be limited because of geographic, economic or healthcare system barriers, particularly in low-resource settings (Dai et al. 2024; Mohan and Sharmil 2023). mHealth apps offer a practical solution to these challenges by providing continuous support outside of clinical settings (Edwards et al. 2021; Sandborg et al. 2021). The development of midwifery-led mHealth apps can bridge gaps in maternity care by offering personalised assessments, educational content and direct communication with midwives (Dai et al. 2024). These apps can help alleviate the challenges posed by the shortage of midwifery staff, particularly in regions where healthcare resources are limited. Women in underserved areas can access reliable health information, self-monitor their progress and receive timely feedback from healthcare professionals, thus ensuring continuity of care throughout their pregnancy. Traditional antenatal care often involves multiple in-person visits, which can be burdensome for pregnant women, especially those living in remote areas or those with limited mobility. mHealth apps reduce the need for frequent visits by allowing women to monitor their health parameters, such as weight gain, blood pressure and fetal movements, and share these data with their healthcare providers (Mazaheri Habibi et al. 2024; Sandborg et al. 2021). This can lead to more efficient use of healthcare resources while maintaining high standards of care. Midwifery-led mHealth apps can also promote informed decision-making by providing pregnant women with tailored health education on topics such as nutrition, physical activity, and mental health (Grundy 2022; Mazaheri Habibi et al. 2024; Mohan and Sharmil 2023). These apps can empower women to take an active role in their health care, improving outcomes for both the mother and the baby.

Health literacy is a significant factor in pregnancy outcomes. Many women, especially those in underserved populations, may have limited access to reliable health information (Dai et al. 2024). mHealth apps offer an accessible platform for disseminating evidence-based health education, helping women better understand their pregnancy and the steps they can take to maintain a healthy lifestyle (Mazaheri Habibi et al. 2024). By providing easy-to-understand information in a digital format, these apps can improve health literacy, reduce anxiety, and promote healthier behaviours (Mazaheri Habibi et al. 2024). Moreover, mHealth apps can foster a sense of empowerment by encouraging women to take control of their pregnancy journey (Dai et al. 2024). For instance, women can track their progress, set health goals and receive feedback on their achievements, all of which can enhance their motivation and adherence to healthy lifestyle recommendations (Sandborg et al. 2021). Studies have shown that self-monitoring and feedback features in mHealth apps are associated with improved dietary habits, increased physical activity and better overall health during pregnancy. One of the most significant advantages of mHealth interventions is their potential to facilitate behaviour change. Apps that promote healthy dietary habits, physical activity and weight management have been shown to improve pregnancy outcomes (Mohan and Sharmil 2023; Sandborg et al. 2021). For example, the HealthyMoms app, a midwifery-led intervention, was found to support healthier weight gain during pregnancy, particularly among women with overweight or obesity. By providing personalised feedback and goal-setting features, these apps can encourage pregnant women to adopt and maintain healthier behaviours. In addition to promoting physical health, midwifery-led mHealth apps can support mental and emotional well-being. Pregnancy is often a stressful time, and many women experience anxiety and uncertainty about their health and the health of their baby. mHealth apps can provide valuable psychological support by offering resources on stress management, mindfulness and relaxation techniques (Mazaheri Habibi et al. 2024). Moreover, the ability to communicate directly with healthcare professionals through the app can reassure women and address any concerns they may have in real time.

One of the primary challenges associated with mHealth interventions is ensuring data security and privacy. Pregnant women using these apps share sensitive health information, such as their medical history, pregnancy progress and biometric data (Edwards et al. 2021). Ensuring the confidentiality of this data is crucial to maintaining user trust and compliance with privacy regulations. mHealth apps must comply with strict data protection laws, such as the General Data Protection Regulation (GDPR) in Europe, to prevent unauthorised access to personal information. Developers must prioritise secure data storage and transmission to safeguard user privacy and mitigate the risks associated with data breaches (Grundy 2022; Sandborg et al. 2021). Although mHealth apps have the potential to reach a broad audience, not all pregnant women may have access to the necessary technology. In low-resource settings, access to smartphones, reliable internet connections and digital literacy may be limited (Mazaheri Habibi et al. 2024). This digital divide can exacerbate existing health disparities, as women who are unable to use these apps may miss out on the benefits of digital health interventions. To ensure that midwifery-led mHealth apps are accessible to all women, developers must consider strategies to improve digital inclusion. This may involve providing training on how to use the app, offering offline functionality or developing partnerships with community organisations to distribute mobile devices to underserved populations. The integration of mHealth apps into antenatal care also presents medico-legal risks. Healthcare providers must ensure that the information and advice provided through these apps are accurate, evidence-based and compliant with legal and professional standards. Additionally, there are concerns about the liability of healthcare providers if a user experiences adverse outcomes while following the app's recommendations. To mitigate these risks, healthcare professionals must be actively involved in the development and review of mHealth apps. Regular updates to the app's content and functionality are essential to ensure that the information provided remains current and aligned with best practices.

To maximise the effectiveness of midwifery-led mHealth interventions, several key considerations should be taken into account during the app development process. First, developers should adopt a user-centred approach, engaging both pregnant women and healthcare professionals in the design and testing phases. This will ensure that the app meets the needs and preferences of its target users and that the features included are practical and beneficial. Second, future mHealth apps should prioritise integration with existing healthcare systems. By allowing seamless data sharing between pregnant women and their healthcare providers, these apps can facilitate more personalised care and improve clinical decision-making. Moreover, integration with electronic health records can enhance the continuity of care by ensuring that all members of the healthcare team have access to the most up-to-date information about the patient's pregnancy progress (Dai et al. 2024). Lastly, developers should focus on creating scalable and sustainable interventions. mHealth apps have the potential to reach large populations, but their long-term impact will depend on their ability to adapt to different healthcare environments and user needs. Ensuring the sustainability of these interventions will require ongoing investment in app maintenance, user support and data security.

Midwifery-led mHealth app interventions offer a promising solution to many of the challenges associated with traditional maternity care. By providing accessible, real-time support to pregnant women, these apps can improve health outcomes, promote healthier behaviours and enhance the overall pregnancy experience. However, to fully realise the potential of these interventions, developers must address key challenges related to data security, accessibility and medico-legal risks. The future of midwifery-led mHealth apps lies in their ability to integrate seamlessly into existing healthcare systems, provide personalised and evidence-based care and reach underserved populations. As the field of digital health continues to evolve, ongoing research and collaboration between healthcare professionals, app developers and pregnant women will be essential to ensuring the success of these innovative interventions.

在对可访问的实时健康干预需求的推动下，怀孕期间使用移动健康 （mHealth） 应用程序变得越来越普遍。以助产士为主导的移动健康干预措施特别适合解决产前护理方面的差距并确保护理的连续性，特别是对于服务不足的人群（Dai 等人，2024 年;Edwards 等人，2021 年）。这些应用程序允许自我监控，提供教育资源并促进医疗保健专业人员与孕妇之间的沟通，所有这些都有助于促进更健康的怀孕和分娩结果。我们饶有兴趣地阅读了 Dai 及其同事最近发表的题为“评估女性和卫生专业人员对开发以助产士为主导的怀孕移动健康应用程序干预的看法：一项描述性定性研究”（Dai 等人，2024 年），该文章探讨了女性和卫生专业人员对开发助产士主导的 mHealth 应用程序干预进行产前保健的看法以及他们对应用程序功能的需求。我们写信是为了表达我的兴趣并探索助产士主导的移动健康干预的日益增长的作用，借鉴最近研究的见解来分析其潜在的好处、局限性和挑战。

助产士是许多孕妇的主要照顾者，她们在提供注重身心健康的整体护理方面具有得天独厚的优势（Dai 等人，2024 年）。然而，由于地理、经济或医疗保健系统障碍，特别是在资源匮乏的环境中，获得助产护理的机会可能会受到限制（Dai 等人，2024 年;Mohan 和 Sharmil 2023）。移动医疗应用程序通过在临床环境之外提供持续支持，为这些挑战提供了实用的解决方案（Edwards 等人，2021 年;Sandborg 等人，2021 年）。以助产士为主导的移动健康应用程序的开发可以通过提供个性化评估、教育内容和与助产士的直接沟通来弥合孕产妇护理方面的差距（Dai 等人，2024 年）。这些应用程序可以帮助缓解助产士人员短缺带来的挑战，尤其是在医疗保健资源有限的地区。服务欠缺地区的妇女可以获得可靠的健康信息，自我监测自己的进展，并从医疗保健专业人员那里获得及时的反馈，从而确保整个怀孕期间护理的连续性。传统的产前保健通常涉及多次面对面检查，这对孕妇来说可能是负担，尤其是那些生活在偏远地区或行动不便的孕妇。mHealth 应用程序允许女性监测她们的健康参数，例如体重增加、血压和胎动，并与她们的医疗保健提供者共享这些数据，从而减少了频繁就诊的需要（Mazaheri Habibi 等人，2024 年;Sandborg 等人，2021 年）。这可以更有效地利用医疗保健资源，同时保持高标准的护理。 以助产士为主导的 mHealth 应用程序还可以通过为孕妇提供关于营养、身体活动和心理健康等主题的定制健康教育来促进明智的决策（Grundy 2022;Mazaheri Habibi 等人，2024 年;Mohan 和 Sharmil 2023）。这些应用程序可以让女性在医疗保健中发挥积极作用，改善母亲和婴儿的结局。

健康素养是影响妊娠结局的一个重要因素。许多女性，尤其是那些服务不足人群的女性，可能难以获得可靠的健康信息（Dai 等人，2024 年）。移动健康应用程序为传播循证健康教育提供了一个可访问的平台，帮助女性更好地了解自己的怀孕情况以及她们可以采取哪些措施来保持健康的生活方式（Mazaheri Habibi 等人，2024 年）。通过以数字格式提供易于理解的信息，这些应用程序可以提高健康素养、减少焦虑并促进更健康的行为（Mazaheri Habibi 等人，2024 年）。此外，mHealth 应用程序可以通过鼓励女性掌控自己的怀孕过程来培养赋权感（Dai 等人，2024 年）。例如，女性可以跟踪自己的进展，设定健康目标并获得有关她们成就的反馈，所有这些都可以提高她们对健康生活方式建议的积极性和依从性（Sandborg 等人，2021 年）。研究表明，移动医疗应用中的自我监测和反馈功能与改善怀孕期间的饮食习惯、增加身体活动和改善整体健康状况有关。移动医疗干预最显著的优势之一是它们有可能促进行为改变。促进健康饮食习惯、体育锻炼和体重管理的应用程序已被证明可以改善怀孕结果（Mohan 和 Sharmil 2023 年;Sandborg 等人，2021 年）。例如，HealthyMoms 应用程序是一项由助产士主导的干预措施，被发现可以支持怀孕期间更健康的体重增加，尤其是对于超重或肥胖的女性。 通过提供个性化反馈和目标设定功能，这些应用程序可以鼓励孕妇采取并保持更健康的行为。除了促进身体健康外，助产士主导的 mHealth 应用程序还可以支持心理和情绪健康。怀孕通常是一个压力很大的时期，许多女性对自己的健康和婴儿的健康感到焦虑和不确定性。移动健康应用程序可以通过提供有关压力管理、正念和放松技巧的资源来提供有价值的心理支持（Mazaheri Habibi 等人，2024 年）。此外，通过该应用程序直接与医疗保健专业人员交流的能力可以让女性放心并实时解决她们可能遇到的任何担忧。

与 mHealth 干预相关的主要挑战之一是确保数据安全和隐私。使用这些应用程序的孕妇会共享敏感的健康信息，例如她们的病史、怀孕进度和生物识别数据（Edwards 等人，2021 年）。确保这些数据的机密性对于维护用户信任和遵守隐私法规至关重要。移动医疗应用必须遵守严格的数据保护法律，例如欧洲的《通用数据保护条例》（GDPR），以防止未经授权访问个人信息。开发人员必须优先考虑安全的数据存储和传输，以保护用户隐私并降低与数据泄露相关的风险（Grundy 2022;Sandborg 等人，2021 年）。尽管移动医疗应用程序有可能覆盖广泛的受众，但并非所有孕妇都能获得必要的技术。在资源匮乏的环境中，使用智能手机、可靠的互联网连接和数字素养的机会可能会受到限制（Mazaheri Habibi 等人，2024 年）。这种数字鸿沟会加剧现有的健康差距，因为无法使用这些应用程序的女性可能会错过数字健康干预的好处。为了确保所有女性都能使用以助产士为主导的移动医疗应用程序，开发人员必须考虑提高数字包容性的策略。这可能涉及提供有关如何使用该应用程序的培训、提供离线功能或与社区组织建立合作伙伴关系，以将移动设备分发给服务不足的人群。将 mHealth 应用程序整合到产前保健中也存在医学法律风险。 医疗保健提供商必须确保通过这些应用程序提供的信息和建议准确、循证并符合法律和专业标准。此外，人们担心如果用户在遵循应用程序的建议时遇到不良后果，医疗保健提供者会承担责任。为了降低这些风险，医疗保健专业人员必须积极参与 mHealth 应用程序的开发和审查。定期更新应用程序的内容和功能对于确保提供的信息保持最新并符合最佳实践至关重要。

为了最大限度地提高助产士主导的移动医疗干预措施的有效性，在应用程序开发过程中应考虑几个关键因素。首先，开发人员应采用以用户为中心的方法，在设计和测试阶段让孕妇和医疗保健专业人员参与进来。这将确保该应用程序满足其目标用户的需求和偏好，并且所包含的功能实用且有益。其次，未来的移动医疗应用程序应优先考虑与现有医疗保健系统的集成。通过允许孕妇和她们的医疗保健提供者之间无缝共享数据，这些应用程序可以促进更加个性化的护理并改善临床决策。此外，与电子健康记录的集成可以通过确保医疗团队的所有成员都能获得有关患者怀孕进展的最新信息来增强护理的连续性（Dai 等人，2024 年）。最后，开发人员应专注于创建可扩展和可持续的干预措施。移动医疗应用程序有可能覆盖大量人群，但其长期影响将取决于它们适应不同医疗保健环境和用户需求的能力。确保这些干预措施的可持续性需要对应用程序维护、用户支持和数据安全进行持续投资。

助产士主导的 mHealth 应用程序干预为与传统孕产妇护理相关的许多挑战提供了一个有前途的解决方案。通过为孕妇提供可访问的实时支持，这些应用程序可以改善健康状况，促进更健康的行为，并增强整体怀孕体验。然而，为了充分实现这些干预措施的潜力，开发人员必须解决与数据安全、可访问性和法医风险相关的关键挑战。以助产士为主导的移动医疗应用程序的未来在于它们能够无缝集成到现有的医疗保健系统中，提供个性化和循证护理，并覆盖服务不足的人群。随着数字健康领域的不断发展，医疗保健专业人员、应用程序开发人员和孕妇之间的持续研究和合作对于确保这些创新干预措施的成功至关重要。