**Background:** Timely access to obstetric and gynecologic healthcare improves maternal and neonatal outcomes, but the COVID-19 pandemic severely disrupted pregnancy care globally. Digital technologies such as mHealth and telehealth have become vital health system strengthening tools, yet no single study had assessed a combination of digital-enabled technologies implemented during the coronavirus crisis to support pregnancy care. This global scoping review aimed to identify peer-reviewed articles that used mobile phone and telehealth health interventions to improve pregnancy care and/or outcomes during the COVID-19 pandemic.
**Methods:** The review followed Arksey and O'Malley's framework and the PRISMA extension for Scoping Reviews. Databases searched included MEDLINE, PubMed, Scopus, CINAHL, and Web of Science. The search was conducted in May 2022 and included peer-reviewed studies published from January 2019 to May 2022. Inclusion criteria were studies leveraging digital health interventions (mobile phone, telehealth, or video conferencing) to enhance access to or linkage with pregnancy care services (perinatal, pregnancy, or postpartum) and improve maternal and neonatal outcomes. Two independent reviewers screened articles, and a third validated data extraction. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies; studies with a total score <13 were excluded.
**Key Results:** The search identified 1851 peer-reviewed articles. After removing 30 duplicates and excluding 1713 non-empirical studies, 108 studies underwent full-text review. After excluding 85 studies (18 after quality assessment), 22 studies were eligible for inclusion. mHealth interventions accounted for 72.7% (16 of 22 studies) and telehealth for 27.3% (6 of 22 studies). Only 3 studies integrated digital technologies into healthcare systems, and only 3 developed and evaluated the feasibility of mobile apps. Experimental studies accounted for 68.8% of mHealth studies and 33.3% of telehealth studies. The 16 mHealth studies included 5 RCTs, 2 quasi-experimental studies, 1 mixed methods study, 2 observational studies, and studies using multistage iterative development or user-centered design. The 6 telehealth studies included 2 experimental studies, 3 evaluation studies, and 1 retrospective chart review. Studies were conducted in the USA (n=4 mHealth; n=1 telehealth), Iran (n=3 mHealth; n=1 telehealth), Australia (n=1 each), and one each in Canada, Guatemala, Indonesia, Mozambique, Singapore, Sri Lanka, UK, Germany, and Spain. Key functionalities of pregnancy apps and telehealth platforms focused on mental and physical wellness, health promotion, patient tracking, health education, and parenting support. For mental and physical wellness, Smith et al. (2021) randomized 101 women and found significant reductions in perceived stress, depression, anxiety, and sleep disturbance in the intervention group using the Calm app. Kubo et al. (2021) reported improvements in pre-post intervention scores for depression symptoms, perceived stress, sleep disturbance, and mindfulness in 27 pregnant women using Headspace™. For health promotion, Leight et al. (2022) conducted an RCT with 5623 women in Mozambique and found that text reminders significantly increased clinic visits for family planning. For parenting support, Ceballos et al. (2020) conducted a cRCT with 1542 households and found phone call response rates were 5 times higher than SMS (75.8% vs. 14.4%). For telehealth, Oelmeier et al. (2022) reported 95% (71/75) patient satisfaction with video consultations but technical problems in 37% (29/75) of appointments. Palmer et al. (2021) used an interrupted time-series analysis of 2292 women and found telehealth enabled a 50% reduction in in-person consultations without compromising pregnancy outcomes.
**Clinical Implications:** The review demonstrates that digital health interventions such as mHealth and telehealth have potential for supporting pregnancy care during emergencies and are vital health system strengthening tools globally. Facilitators of uptake included perceived benefits, user satisfaction, convenience, ease of use, and low literacy requirements. However, the review emphasizes a lack of robust studies and data from pregnant women during the COVID-19 crisis. There is a need for more randomized clinical trials and longitudinal studies to better understand the effectiveness and feasibility of implementing such interventions during disease outbreaks and emergencies. The findings support the use of digital technologies to maintain continuity of maternity care during public health emergencies.