Classication of Pregnancy Apps in Medical Technology Despite the Coronavirus

The use of mobile applications is very popular among the public these days. Pregnant women are a segment of society who need constant care to monitor their condition and that of the fetus. Pregnant women nd it very dicult to keep track of their condition. An application software is needed. But choosing a reliable application is important. The article is a research article that uses PRISMA owchart to extract articles. Given that there are many apps in the eld of pregnancy and due to technological advances as well as the recent outbreak of coronavirus disease, so the articles of the last 10 years that have been scientically published in the databases of Google Scholar, PubMed, Science Direct have been analyzed. The most widely used and at the same time the best app is introduced in terms of its high usability. the general pregnant Finally, 10 apps were selected its high


Background
In today's world of technology, electronic devices such as cell phones and tablets have become an essential tool in everyday life. Whether used for formal or personal purposes, these devices in uence and shape the way people think and live. The rapid development of Internet-based communication technologies over the past twenty years has changed the lifestyles of people around the world. Residents of cities and villages can equally access the opportunities used by mobile devices. (1)(2)(3) When it comes to women's health and addressing important issues such as childbirth and pregnancy, the most important thing is to constantly monitor the health of the mother and fetus. In the past, due to unnecessary considerations due to ignorance, information about pregnancy and childbirth was usually done incompletely and with strange restrictions. Some even considered educating and informing people about this natural issue an ugly act. (4)(5)(6)(7) But fortunately, over time, extremist views have largely disappeared, so that today there are many tools to inform young women about the important issue of pregnancy and maintaining their health during this critical period. (8)(9)(10)(11) Today, with the signi cant advancement of medical technologies in the eld of pregnancy and childbirth, the world of applications and websites has entered all aspects of human life, including pregnancy. (12) These days, you can rarely see a pregnant woman who is unaware of the gender and health status of her fetus, or you can almost say that you will not nd any urban mother who goes to the virtual networks to solve the problems of pregnancy, breastfeeding and child care. (13) Therefore, the category of motherhood has been and is a very lucrative and popular subject for launching startups in the world, so that if you look at virtual stores, you can encounter with a considerable variety of apps and websites in the eld of motherhood. Since children need educational facilities and special care to grow, and it is time consuming for parents to do all the activities related to proper care and proper nutrition, ideas have been developed to help them in this important matter. (14,15) Today, the use of apps is more popular than websites. As a result, most reputable sites in the eld of pregnancy have designed apps that usually use tools such as estimating the time of delivery, calculating BMI, determining gender, calculating the required calories, scheduling the vaccine, searching for the baby's name, etc. in this program are included that can be easily used. In addition to the above tools, the "Pregnancy and Childhood Calendar" is also one of the most popular sections of the applications, which provides accurate and complete articles from the rst week of pregnancy to the 41st week of pregnancy. (16)(17)(18)(19)(20)(21)(22)(23)(24) Today, from the topic of pregnancy health and counseling in this eld to counseling for buying clothes, designing a room and preparing baby food, everyone is discussing and progressing in the context of applications. There are also many websites that work in this eld and are a kind of database for young mothers. (3,17,19,25) But despite the multiplicity of these apps, choosing the best type has become di cult for pregnant women. On the other hand, the reliability of the software, its accuracy and precision, and nally how to use it is very important. However, the main concern is the quality of these programs. Therefore, there is a need to monitor the quality of information provided by these pregnancy programs. In the development of interactive mobile applications, one of the main factors that determine their success is usability. However, although many researchers have done research on mobile health-related applications, many of these studies are inaccurate.
On the other hand, despite coronavirus disease, traveling is a dangerous act for pregnant women, and using the app can reduce their travel to some extent and provide them with the necessary information and measurement.
However, the quality, reliability and effectiveness of existing pregnancy programs have not yet been determined. Therefore, exposure to potentially harmful programs or participation in research with evidence-based mobile applications should be carefully considered, especially during pregnancy when women are more sensitive to external in uences. In addition, unnecessary information and advice about lifestyle and health care can cause more anxiety and stress during pregnancy. Therefore, information on usability and effectiveness is very important for implementing new programs in maternal health care. (4,14,15,20,22,23,26) In this research article, pregnancy apps will be categorized rst and then they will be compared in terms of accuracy, precision and usability of the dimensions of Jacob Nielsen's ve principles, it will be given users a detailed view to choose the best type of app.

Methods
This article is a research article. First by searching for the keywords mHealth, pregnancy, mobile app, mobile phone and covid-19 and coronavirus, as well as combining the keywords in the Google Scholar, PubMed and Science Direct databases in the period October 2010 to October 2020, a total of 313 articles extracted. Then, considering the inclusion and exclusion criteria ( Table 1) and also reviewing the abstracts of articles by both authors separately, nally 23 articles were included in the study. Of these 23 articles, 10 apps were reviewed according to inclusion and exclusion criteria. Flowchart 1 shows the study selection chart.

Results
Of the 23 studies, 78% were conducted in Malaysia, China, the United States and Australia. The apps reviewed in these articles included the dimensions of weight control, week-to-week care, pregnant mothers, and examining mothers' physical and mental condition, choosing a name for their child, and purchasing supplies. Table 2 shows the categories of different dimensions of pregnancy apps. There were a total of 251 apps on Google Play related to pregnant women, only a fraction of which have been scienti cally reviewed, which is actually done in Table 2 of this category. One of the most important parts of the app category is the information section. The information must be up-to-date and credible, and on the other hand, it must take into account all sections of the pregnant woman and the scienti c texts must be expressed in simple language.
On the other hand, it is one of the sub-sections of information about speci c pregnancies, which includes women with certain diseases such as diabetes, asthma and hypertension, which were excluded from the present study. On the other hand, identifying the quality of apps also requires examining quality indicators such as usability (Table 3). Table 4 classi es the quality of pregnancy apps based on the dimensions of Nielsen's ve principles of accuracy and precision. Figure 1 shows a graph of user satisfaction with pregnancy software based on reports of app satisfaction on Google Play and the App Store. -Free pregnancy app. Figure 2 shows part of this software. As shown in the gure, the menu of this app has become more attractive in the 2020 update and has provided the ability to access different sections more quickly. Important parts of this software include weight monitoring, pregnancy exercises such as pregnancy yoga, weekly pregnancy information, and communication with the doctor, exchanging views with other mothers and using the experiences of pregnant women, pregnancy calendar and taking notes in it (7,12).

Discussion
In this research article of category pregnancy apps and Amila app according to Table 4 in terms of usability, accuracy and precision received the highest score compared to other apps and was suggested as a reliable app to pregnant women and experts in this eld. According to the evaluation of this program, Nielsen usability criteria were obtained with an average of 71.824%. Given that there are many pregnancy apps in the Apple Store and Google Play, nding the most reputable ones is very di cult and requires scienti c research, which is addressed in this study. Out of 23 extracted articles, we reached a total of 10 apps for which usability criteria were examined. decision research that provides and collects risk information related to preterm delivery. In the new update, satisfaction is 56%. And due to the similarities with other software and lacked some of the features of Table 2, was not selected for this study and did not enter the study. Because in this study, articles that had all the features of Table 2 were reported. (36) In general, it can be concluded that due to the high volume of pregnancy apps and the lack of review of many of them in terms of usability, a research article to review such apps in terms of user-friendliness and user satisfaction is important for pregnant women and professionals in this eld. Given that many apps in the eld of pregnancy are commercial and there is no scienti c article about them, so they did not participate in the present study (1, 16-18, 28, 37) which is one of the main limitations of this article and the strength of the article is that the apps reported in this article has been scienti cally validated by experts.

Conclusion
Today, the use of smartphones has grown signi cantly and most people use mobile apps instead of websites. Due to the prevalence of coronavirus and the risk of pregnant women, most pregnant women have turned to apps to reduce their travel to nd out about their status. (16, 17, 19-21, 23, 24, 38, 39) But using a reputable and reliable app is also very important.
Because a search on Google Play or the App Store shows a large number of apps for them, many of which may not be scienti cally quali ed. (40)(41)(42)(43)(44)(45)(46) In this article, the best apps that are also popular from the users' point of view were introduced so that not only pregnant women but also obstetricians can use them. Some of the available apps were designed speci cally for pregnant mothers.
Mothers with underlying diseases such as diabetes, asthma and high blood pressure. Such apps were excluded from the study because they included a certain segment of pregnant women, and nally 10 of the most widely used apps in the eld of pregnancy were selected, which were approved by users and scienti cally evaluated. Finally, the Amila app was selected as one of those apps that not only provides the required information to mothers, but also the ability to interact with doctors and specialists, due to its higher accuracy, precision and usability than other apps. Also gives and the user can use it with peace of mind. Availability of data and materials: It has done by searching in relevant databases.