Better Understanding the Metamorphosis of Pregnancy (BUMP)

@article{Health Data Nexus-bump-1.0.0,
  author = {Yang, Robin and Karlin, Emma and Goodday, Sarah and Friend, Stephen},
  title = {{Better Understanding the Metamorphosis of Pregnancy (BUMP)}},
  journal = {{Health Data Nexus}},
  year = {2026},
  month = nov,
  note = {Version 1.0.0},
  doi = {10.57764/wzsc-f390},
  url = {https://doi.org/10.57764/wzsc-f390}
}

Abstract

The BUMP study was a longitudinal, feasibility study conducted by 4YouandMe. The purpose of the study was to gain a deeper understanding of the pre-pregnancy and pregnancy individual-level symptom experience through the use of wearable devices, smart scales and smartphone apps. Participants provided data through two 4YouandMe study apps (BUMP for pregnant individuals, and BUMP-Conception(C) for individuals attempting to get pregnant, but not yet pregnant), an Oura smart ring, a Garmin smartwatch and a Bodyport Cardiac Scale. Electronic health data was collected through a third party company and additional administrative, survey and unstructured context data was collected on bi-weekly research coordinator check-in calls.

Background

The BUMP study was designed to derive novel insights and deeper understanding of the pre-pregnancy and pregnancy experience with an aim to follow 7 core symptoms (emesis, fatigue, edema, mood, cognition, dyspnea, and blood pressure changes) through the use of connected devices such as wearable devices, smarthome scales and smartphone apps. The study goal was to learn how to provide knowledge and support to women during this major period of change. Despite pregnancy being a commonly occurring medical event that poses health risks to the pregnancy woman and fetus, there is limited understanding of individual level experiences and on how to prevent and treat symptoms before they become higher risk complications

The specific objectives of the BUMP study were to:

1. Demonstrate the feasibility of the collection and integration of digital and clinical data from pregnant women or women trying to conceive using engagement strategies focused on support and knowledge
2. Characterize the inter-/intra-individual variation in objective and subjective pregnancy-related symptoms and signs (blood pressure changes, emesis, fatigue, mood, sleep, dyspnea, cognition, edema, gait, and other)
3. Characterize the inter-/intra-individual variation in objective and subjective pre-pregnancy-related symptoms and signs associated with fertility treatments (i.e., mood, cognition, sleep, anxiety, irritability, anger, fatigue, vasomotor, other)
4. Determine individual-level patterns in subjective and objective data that are associated with pregnancy-related complications, severe symptoms, and diseases

Methods

Study Population

The BUMP study included two cohorts of women. The BUMP cohort included women who are currently pregnant, and the BUMP-Conception (C) cohort included women actively attempting to get pregnant. Trying to conceive is defined by a variety of methods including spontaneous conception, or any form of fertility treatment that could include oral/injectable treatments or other assisted reproductive treatments such as in vitro fertilization (IVF). Inclusion and exclusion criteria for the BUMP and BUMP-C cohorts are detailed below:

Inclusion Criteria

• Pregnant (up to and including 15 weeks) (BUMP cohort)
• Anticipating to be pregnant (BUMP-C cohort)
• 18+ years (BUMP cohort)
• 18-40 years (BUMP-C cohort)
• Has a personal cell phone that is an iPhone SE or newer or an Android device, version 6.0 or newer, and is willing to upgrade to the most recent operating system and use their phone for study (This includes a willingness to download and use the study applications and sync their phone with the necessary study devices)
• Has an unshared email address
• Proficient in English language

Exclusion Criteria

• Prisoner
• Unable to read or understand the study materials
• Does not have a permanent address
• Intention to terminate pregnancy at the time of enrollment

Recruitment

Enrollment in the BUMP study began in February 2021. The primary form of recruitment was through the Sema4 patient portal. Patients who completed a Sema4 test commonly associated with pregnancy (e.g., non-invasive prenatal testing, expanded carrier screening) and consented to have their EMR data accessed by Sema4 received an email notification from Sema4 with a brief description of the study and option to provide contact information so that a study representative could contact them. Participants were also recruited through partnership with Community Health Centers Inc (CHCI) community clinics, social media, and word of mouth.

BUMP participants were asked to participate through the duration of their pregnancy and up to three months postpartum. BUMP-C participants were followed for six months or until conception, whichever comes first. These participants had the option of transitioning to the BUMP cohort if they became pregnant. Additionally, participants who completed 6 months in the BUMP-C cohort without conceiving and became pregnant after their BUMP-C participation, were able to enroll in the BUMP cohort at any point during the enrollment period by contacting the study team.

Data Sources

Biometric Data - BUMP participants were provided with a Bodyport scale, Garmin smartwatch, and Oura 2 smartring. They were instructed to use the Bodyport scale once a day and wear the Oura and Garmin continuously through the duration of their study participation. Starting in October 2021, participants were given the option to opt in to sharing their Apple healthkit data and use a personal Apple watch, in lieu of wearing the study-provided Garmin smartwatch. BUMP- C participants were provided with the Oura 2 smartring only and asked to use it continuously through their study participation.

Engagement Expert (EE) Check-Ins - Participants were paired with an “Engagement Expert” (EE), a designated study team member to support them through the duration of the study. Participants were asked to engage in biweekly check-ins via phone call with their EE. These calls were used to collect qualitative data on the pre-pregnancy and pregnancy experience, provide administrative support to participants, and facilitate a collaborative environment where participants were encouraged to provide feedback and act as co-designers of the study.

Study App - Participants completed daily and intermittent active tasks and surveys through a study app to provide information on sleep, mood, cognition, and symptoms. Evidation Health developed two study apps, the BUMP app and the BUMP-C app for use by the respective cohort of participants. The study apps also provided a central hub for the study where participants completed their Econsent, connected their wearable devices, and could monitor their own participation and data.

Clinical Data - Participants provided objective clinical data by sharing their EMR through a secure platform. This data was used to extract information regarding participants' perinatal care and medical history.

Data Description

The BUMP dataset contains de-identified longitudinal data collected from pregnant individuals participating in a digital health study conducted by 4YouandMe. The dataset captures continuous wearable data, self-reported surveys, and app-logged entries across the entire duration of pregnancy, with a subset of participants enrolled in BUMP-C - a related sub-study that began data collection at the time of conception. Data were collected from 630 unique participants across both BUMP and BUMP-C.

The dataset includes high-frequency biometric data from devices such as the Oura Ring (e.g. heart rate variability, resting heart rate, sleep, activity, and temperature) and Bodyport Smart Scale (e.g. weight, BMI). Daily and weekly self-reported survey data captured mood, fatigue, cognition, stress, physical symptoms, and lifestyle factors. The dataset also includes medical history, pregnancy complications, delivery outcomes, and postpartum recovery information.

A comprehensive data dictionary is available as part of the BUMP documentation, detailing all variables, units, and the collection schedule for each measure.

Usage Notes

The BUMP dataset is used to study physiological and psychological changes throughout pregnancy using a combination of wearable sensor data and self-reported surveys. Researchers analyze the variables obtained from the study to better understand pregnancy trajectories, identify potential risk patterns, and explore early predictors of delivery and health outcomes. 

External Documentation: Data Dictionary outlining and defining all data variables collected, as well as the timing and frequency of data collection for each variable

Related Software Developed: A custom mobile application was developed for iOS and Android that facilitated participant engagement, collected survey data, and synchronized wearable device data. Source code for the app and data pipeline is hosted in a private 4YouandMe GitHub repository

Ethics

This study was approved by the IRB, Advarra (Pro00047893).

Conflicts of Interest

No conflicts of interest