(P27-021-25) The Effects of a Co-developed Perinatal e-health Intervention for Underserved Women on Maternal Diet: A Secondary Analysis of the “SmartMoms in WIC” Randomized Clinical Trial

Objectives: The United States face high rates of maternal morbidity and mortality, particularly in the “Deep South” where socioeconomic disparities and health inequities are prevalent. Nutrition during pregnancy plays an important role in reducing the risk of adverse perinatal outcomes and managing gestational weight gain. The “SmartMoms in WIC” trial enrolled underserved pregnant people in Louisiana in a perinatal intervention with the goal of promoting appropriate gestational weight gain through an educational curriculum focused on diet and physical activity combined with self-monitoring behaviors. The aim of this secondary analysis was to determine the intervention effects on maternal diet.

Methods: Pregnant people (N=351) enrolled in the Louisiana Special Supplemental Nutrition Assistance, Women, Infants, and Children (WIC) program were randomized to a multicomponent e-Health intervention for gestational weight management co-developed with community stakeholders or Usual Care. The Intervention Group received nutritional guidance aimed at aligning eating patterns with the USDA Dietary Guidelines via weekly video lessons, virtual health coach check-ins, and resources (e.g., recipes using WIC-approved foods). Dietary intake (total energy and macronutrient intake) and diet quality (alternative healthy eating index) was assessed during early and late pregnancy via dietary recall (ASA24).

Results: Energy intake remained stable in the Intervention Group from early to late pregnancy (-44 kcal/d; 95% CI: -179, 92) compared to an increase in the Usual Care Group (263 kcal/d, 95% CI: 123, 402), resulting in a significant between-group difference (-306 kcal/d; 95% CI: -500, -112; P=0.002). Significant intervention effects were observed for macronutrients; compared to Usual Care, the Intervention Group had a smaller increase in carbohydrate and fat intake (g/day), and a greater increase in protein intake (% of energy intake). In contrast, the intervention did not affect diet quality.

Conclusions: The “SmartMoms in WIC” intervention stabilized energy intake mainly driven by changes in fat and carbohydrate intake among pregnant participants without affecting overall diet quality.

Funding Sources: National Institute of Nursing Research; Louisiana/Pennington Nutrition and Obesity Research Center; Louisiana Clinical and Translational Sciences Center