Effects of mHealth Interventions on Gestational Weight Management in Pregnant Women with Overweight or Obesity: A Systematic Review and Meta-Analysis.

CONTEXT: Overweight/obesity in pregnancy heightens adverse outcomes. Mobile health (mHealth) interventions are promising, but its effectiveness in gestational weight management in pregnant women with overweight or obesity remains unclear. OBJECTIVE: The objective of this study was to evaluate the impact of mHealth interventions on gestational weight management and maternal-infant outcomes in this population. DATA SOURCES: We searched 8 databases for randomized controlled trials from inception to November 16, 2025. DATA EXTRACTION: Primary outcomes were total gestational weight gain (GWG) and excessive GWG (EGWG) rate. Multiple subgroup analyses were conducted. Secondary outcomes were maternal-infant health outcomes. We assessed the risk of bias with the Cochrane risk-of-bias tool RoB2.0 and appraised the overall evidence quality using the GRADE criteria. DATA ANALYSIS: A total of 22 RCTs (n = 3284) were included. mHealth interventions probably result in a slight reduction in total GWG (mean difference = -1.23 kg, 95% CI: -1.80 to -0.87) and reduce the risk of EGWG (OR = 0.62, 95% CI: 0.44 to 0.88). Subgroup analyses revealed that the effect on total GWG was not significant for women with obesity alone. Both digital-only and digital-mixed interventions probably reduced total GWG; however, digital-mixed interventions appear to yield more favorable effects in preventing EGWG compared with digital-only approaches. Interestingly, non-theory-based interventions reduced total GWG, whereas theory-based interventions did not. The evidence for all maternal and neonatal clinical outcomes was rated as having very low certainty, and no significant improvements were observed. CONCLUSIONS: The evidence suggests that mHealth interventions may result in a slight reduction in total GWG and may slightly reduce the risk of EGWG in pregnant women with overweight or obesity. However, the certainty of this evidence is low to moderate, and mHealth interventions may have little to no effect on maternal and neonatal clinical outcomes. Further high-quality randomized trials are needed to confirm these findings and to evaluate the long-term effects of mHealth interventions. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No.: CRD420251186464. .