Ku Chee Wai weaves hope in reproductive medicine

Obstetrics and Gynaecology have always been special for me. To me, it is “happy medicine”—a rare specialty where I can congratulate patients on the arrival of a new life and see the smiles on their faces when they find out whether it’s a girl or a boy.

I wanted to see more such smiles. So for my next project, I worked on a new lifestyle intervention tool to help women with overweight or obesity issues assess and guide their eating behaviour before, during and after pregnancy. Called 6P, the tool breaks nutrition and physical activity into six components: portion, proportion, pleasure, phase, physicality and psychology.

We implemented the tool in a study where participants answered questions related to these components, e.g., diet and physical activity, on a digital platform, which then generated recommendations on healthy eating. More than 80 per cent of the study participants agreed that the 6P tool was useful in guiding them towards a healthier diet.

Using digital platforms to improve pregnancy care // Credit: Norfaezah Abdullah, Duke-NUS

Building on this work, the 6P tool was rolled out in a single-arm implementation trial called “Healthy Early Life Moments in Singapore (HELMS)”. This is a digital intervention, featuring educational modules from preconception to pregnancy and postpartum periods. The app provides advice and guides goal-setting on lifestyle behaviours that include diet, physical activity, mental wellness and sleep hygiene. It aims to help women with overweight or obesity issues improve their metabolic and mental health before, during and after pregnancy, as well as improve their baby’s growth in his/her early stages of life.

We received positive feedback for the project and launched the web application in 2022. A year later, it became available on the Health Buddy mobile application, and provides access to health information and services.

With the preconception phase completed, we will continue our follow-up for those who are pregnant and those who have delivered their baby. This will take another two to three years as we evaluate the efficacy of this intervention.

What I have observed, in the meantime, is encouraging though. I follow-up with every study participant during their study visits until they deliver. It is heartening when they tell me that they’ve made a positive change to their lifestyle after joining the programme. For example, many have switched from full-sugar options to no-sugar options when buying their favourite drink.

Satisfying as it may be, such research projects require substantial commitment. A typical day in my life involves starting work as a clinician at 7am. I end my clinical work at around 6pm and head home to spend time with my wife, two children, aged 3 years and 8 months respective, and my dog! (That’s if I’m not on call or get called back for a delivery.) Most days of the week, I then start my research meetings or research work around 9.30pm and sometimes, those meetings or my research work can continue till later.

Building a strong foundation for healthy women // Credit: Norfaezah Abdullah, Duke-NUS

What keeps me going is knowing that by improving the health of the mother, the child's health will be optimised too. If we can improve the health of the mother, we can break the vicious cycle of ill-health and improve the health of her baby. I will continue with my research efforts and I am grateful to my family, the Department of Reproductive Medicine in KKH, as well as the HELMS team, who have all played a huge part in building a strong foundation for healthy women and secure a better start for future generations.

As told to Alice Chia, Senior media and content specialist.