Abstract
BACKGROUND: Mobile health (mHealth) has emerged as a scalable strategy for delivering timely health information and behavioural support to pregnant women. However, its effectiveness as an educational tool to improve maternal health remains unclear. This systematic review compares the impact of mHealth interventions with conventional nutrition education, with a focus on the integration of behaviour change techniques (BCTs) and their influence on maternal outcomes. Unlike earlier reviews, this study applies theory-based framework to identify effective BCTs and compare mHealth with traditional education, addressing existing gaps and guiding targeted intervention design. METHOD: DESIGN: A systematic review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). SETTING: The search systematically spanned five databases (The Cochrane Library, PubMed, Scopus, CINAHL, and ACM Digital Library) of the literature published between 1 January 2015 and 30 November 2024. A systematic quality assessment of the included studies was conducted to evaluate methodological rigor, risk of bias, and the overall reliability of the evidence. PARTICIPANTS: The review included 12 studies involving 1809 pregnant women participating in interventions that employed mobile health applications integrated with BCTs to enhance maternal health outcomes. RESULTS: A total of 1785 publications were initially screened and twelve studies were ultimately included in the systematic review. The mHealth interventions used included mobile apps, web-based platforms, smart bands and short message service, with interventions targeted dietary intake (4 studies), gestational weight gain (3 studies), physical activity (2 studies), psychosocial well-being (2 studies), and maternal perinatal complications (1 study). While mHealth interventions show positive effects on maternal outcomes including gestational weight gain, dietary intake and physical activity, two-thirds of the studies exhibited risk of bias, possibly due to challenges in blinding participants and researchers. CONCLUSIONS: This review highlights the promise of mHealth interventions in improving dietary adherence, physical activity, gestational weight gain, psychosocial well-being and pregnancy outcomes such as birth weight and gestational complications. Despite these promising findings, further research is required to confirm efficacy, cost-effectiveness and implementation scalability of mHealth applications in maternal health care. TRIAL REGISTRATION: As no primary data were collected, clinical trial registration is not applicable.