30 August 2022
The BUMP Study: Using digital tools to gain a deeper understanding of pregnancy symptoms
Earlier this year, members of the Cambridge Cognition team were co-authors on a paper describing a protocol for the Better Understanding the Metamorphosis of Pregnancy (BUMP) study. This study, led by 4YouandMe, is aiming to use digital tools, some of which are provided by Cambridge Cognition, to gain a deeper understanding of the symptoms of pregnancy. Here, we explain the study's aims and why it is important. You can find the full paper here.
Why is this study important?
Maternal health remains a significant global public health problem, with maternal disorders approaching 80 million cases in 2017. While pregnant people are usually monitored frequently via in-clinic visits, little is known about how symptoms change between visits. Pregnancy also affects people differently, with a complex interaction between hormones, existing conditions and mental and physical factors. The frequency and severity of symptoms also varies widely between individuals. These complex factors make each pregnancy experience unique but also create challenges for maternal care protocols, which are based on aggregate and averaged data rather than being tailored to the individual’s own situation.
Wearable devices such as smartwatches and smart rings are now capable of tracking physiological factors such as heart rate, and activity such as exercise. Most studies into pregnancy symptoms track one or two factors. Combining many digital health monitoring tools, including objective measures of cognition, mood, and sleep, could provide a broader picture of overall symptoms and wellbeing in pregnancy while remaining unique to the individual. Monitoring symptoms in this way could help with detecting pregnancy-related symptoms and increase the chances of early intervention, potentially reducing complications.
How is study being conducted?
The goal of the BUMP study is to use wearable devices, smart scales and smartphone apps to build a deeper understanding of pregnancy symptoms at the individual level. The study will follow a total of 1,000 women from before they conceive until the baby is three months old. Data is being captured from self-reported subjective sources as well as the use of objective measures. Participants are recruited via Sema4’s patient portal and includes people who are currently pregnant and those who are actively trying to conceive. Participants wear either an OURA smart ring or Garmin Venu Sq smartwatch for the duration of the study. They are paired with a digital ‘engagement specialist’ who they will be in contact with around once a month for troubleshooting and for qualitative data collection. The study’s participant-centric, co-design approach means the participants are helping to shape the app and their study experience.
This study aims to discover whether it is feasible for digital and clinical data to be collected and integrated throughout the pregnancy journey. It will also help to characterise symptoms that are unique to an individual alongside those that affect many or most pregnant people.
There are two cohorts taking part in the study – people who are currently pregnant (BUMP) and those actively trying (BUMP-Conception or BUMP-C). Two smartphone apps have been developed, one for each cohort. The app has daily and intermittent surveys and active tasks that measure key symptoms associated with hormonal variations in pre-pregnancy or pregnancy. For pregnancy these symptoms include mood changes, sleep, cognition and nausea/vomiting. Similar symptoms are also being targeted for people attempting to conceive alongside factors that might arise from fertility treatments, for example vasomotor symptoms. The app asks participants to fill in a daily survey and uses push notifications to remind them of activities they need to complete. There are daily rewards that are tallied at the end of the study and there will be a modest financial reward.
How are Cambridge Cognition involved?
Cambridge Cognition are providing tasks to measure cognitive and emotional bias (the Cognition Kit N-Back and CANTAB EBT, respectively). The Psychomotor Vigilance Task (PVT) is being used to measure vigilance and reaction time.
What other measures will be used?
Other measures include self-reporting of symptoms, video diaries to capture voice and face data and a gait task. The daily task burden doesn’t exceed five minutes. For sensitive tasks, such as reporting of suicidal thoughts, data is being collected by trained 4YouAndMe specialists via telephone.
What is the goal of the study?
Ultimately, the BUMP study’s goals are to contribute towards the development of a digital personalised health tracker that provides knowledge and support throughout the pregnancy journey. By monitoring pregnancy outside of a clinic setting, these tools have the potential to empower pregnant people to predict when symptoms might become risky. It may also enable pregnant people, particularly from minority backgrounds, to better advocate for themselves in a system where they are subject to the implicit biases of healthcare systems and providers.
Can I join the study?
The BUMP study is actively enrolling participants who are based in the US, are over 18 years old and are up to and including 15 weeks pregnant. You must also own a personal smart phone. Find out more about participating in the study here.
Full author list: S. M. Goodday, E. Karlin, A. Brooks, C. Chapman, D. R. Karlin, L. Foschini, E. Kipping, M. Wildman, M. Francis, H. Greenman, Li Li, E. Schadt, M. Ghassemi, A. Goldenberg, F. Cormack, N. Taptiklis, C. Centen, S. Smith & S. Friend