Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials

doi:10.1111/jan.14588

Review

. 2021 Jan;77(1):125-146.

doi: 10.1111/jan.14588. Epub 2020 Oct 13.

Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials

Pingping Guo¹, Xuehui Zhang¹, Na Liu¹, Jie Wang¹, Dandan Chen¹, Weijia Sun¹, Ping Li², Wei Zhang¹

Affiliations

¹ School of Nursing, Jilin University, Changchun, Jilin, China.
² Department of Developmental Pediatrics, Second Hospital of Jilin University, Changchun, Jilin, China.

PMID: 33048358
DOI: 10.1111/jan.14588

Review

Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials

Pingping Guo et al. J Adv Nurs. 2021 Jan.

. 2021 Jan;77(1):125-146.

doi: 10.1111/jan.14588. Epub 2020 Oct 13.

Authors

Pingping Guo¹, Xuehui Zhang¹, Na Liu¹, Jie Wang¹, Dandan Chen¹, Weijia Sun¹, Ping Li², Wei Zhang¹

Affiliations

¹ School of Nursing, Jilin University, Changchun, Jilin, China.
² Department of Developmental Pediatrics, Second Hospital of Jilin University, Changchun, Jilin, China.

PMID: 33048358
DOI: 10.1111/jan.14588

Abstract
in English, Chinese

Aim: To quantify the effect of mind-body interventions on stress in pregnant women.

Design: A systematic review and meta-analysis of randomized controlled trials was performed.

Data sources: PubMed, Embase, CENTRAL, Web of Science and PsycINFO were searched from each database inception to January 2020.

Review methods: Randomized controlled trials regarding mind-body interventions for stress in pregnant women were included. Methodological quality was evaluated using the Cochrane Collaboration 'Risk of Bias' tool and meta-analysis was performed via RevMan 5.3. Subgroup analysis and publication bias assessment were conducted. Post hoc sensitivity analysis was performed to investigate the source of heterogeneity.

Results: In total, 28 studies comprising 1944 participants were included. The overall meta-analysis showed that antenatal stress of pregnant women in the mind-body interventions groups showed significant high improvements (SMD=-0.94; 95% CI [-1.25, -0.63]; p < .00001) compared with the control groups. Results of subgroup analyses indicated that all types of mind-body interventions including mindfulness intervention, cognitive behavioural therapy, relaxation techniques and yoga were beneficial to antenatal stress. Both groups and individual formats mind-body interventions were effective. 4-8 weeks mind-body interventions were seemed as the optimal choice. Moreover, mind-body interventions were concomitant with reducing antenatal anxiety and depression.

Conclusion: Mind-body interventions are promising approaches for stress reduction in pregnant women. Nevertheless, the results should be interpreted with caution because of high heterogeneity and publication bias. Further high-quality studies are needed to verify the findings.

Impact: Mind-body interventions have been widely implemented to ameliorate antenatal stress, but conflicting results were found across studies. This systematic review and meta-analysis suggested that mind-body interventions are relatively safe and convenient and can successfully promote antenatal stress. The suggestions proposed in this review may be useful for developing a scientific mind-body interventions regimen and encouraging the application of mind-body interventions in pregnant women, thereby managing antenatal stress effectively.

目标: 量化孕妇压力的身心干预措施效果。设计: 对随机对照试验进行系统评价和荟萃分析。数据来源: 搜索国际文献数据库(PubMed)、荷兰医学文摘数据库(Embase)、CENTRAL、科学网(Web of Science)和心理学文摘(PsycINFO)各数据库自成立至2020年1月的所有论文。评价方法: 纳入有关于孕妇压力身心干预措施内容的随机对照试验。使用科克伦协作网(Cochrane Collaboration)“偏差风险”工具评估方法的质量,并通过RevMan 5.3进行荟萃分析。进行子组分析和发表偏倚评估。通过事后比较敏感分析研究异质性的来源。结果: 总共纳入28项研究,涵盖1944名参与者。总体荟萃分析显示,与对照组相比,身心干预组的孕妇产前压力显著提高(SMD=−0.94;95%可信区间[−1.25, −0.63];p <0.00001)。子组分析结果表明,所有类型的身心干预,包括正念干预、认知行为疗法、放松技巧和瑜伽都有利于缓解产前压力。无论是针对团体还是个人,身心干预都有效。4至8周的身心干预似乎是最佳选择。此外,身心干预能同步减少产前焦虑和抑郁。结论: 身心干预是减轻孕妇压力的有效方法。然而,由于异质性高和发表偏倚,应当审慎地解读结果。需要进一步的优质研究来验证研究结果。影响: 身心干预虽然已被广泛应用于缓解孕妇的产前压力,但在不同研究中发现互为矛盾的结果。此次的系统性评价和荟萃分析表明,身心干预相对安全和便捷,可以成功地缓解孕妇的产前压力。本篇评价文章提出的建议可能有助于制定科学的身心干预方案,鼓励对孕妇采用身心干预措施,从而有效地管理其产前压力。.

Keywords: meta-analysis; mind-body intervention; nursing; pregnant women; randomized controlled trial; stress; systematic review.

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References

REFERENCES

1. Akhter, S., Rutherford, S., & Chu, C. (2017). What makes pregnant workers sick: Why, when, where and how? An exploratory study in the ready-made garment industry in Bangladesh. Reprod Health, 14(142), 1-9. https://doi.org/10.1186/s12978-017-0396-0
1. Asghari, E., Faramarzi, M., & Mohammmadi, A. (2016). The effect of cognitive behavioural therapy on anxiety, depression and stress in women with preeclampsia. Journal of Clinical and Diagnostic Research, 10(11), QC04-QC07. https://doi.org/10.7860/JCDR/2016/21245.8879
1. Austin, M. P. V., Middleton, P., Reilly, N. M., & Highet, N. J. (2013). Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines. Women Birth, 26(1), 2-9. https://doi.org/10.1016/j.wombi.2011.12.001
1. Bastani, F., Hidarnia, A., Kazemnejad, A., Vafaei, M., & Kashanian, M. (2005). A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. Journal of Midwifery & Women's Health, 50(4), e36-e40. https://doi.org/10.1016/j.jmwh.2004.11.008
1. Battle, C., Salisbury, A., Schofield, C., & Ortiz-Hernandez, S. (2013). Perinatal Antidepressant Use: Understanding Women’s Preferences and Concerns. Journal of Psychiatric Practice, 19(6), 443-453. https://doi.org/10.1097/01.pra.0000438183.74359.46

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[1] Akhter, S., Rutherford, S., & Chu, C. (2017). What makes pregnant workers sick: Why, when, where and how? An exploratory study in the ready-made garment industry in Bangladesh. Reprod Health, 14(142), 1-9. https://doi.org/10.1186/s12978-017-0396-0

[2] Akhter, S., Rutherford, S., & Chu, C. (2017). What makes pregnant workers sick: Why, when, where and how? An exploratory study in the ready-made garment industry in Bangladesh. Reprod Health, 14(142), 1-9. https://doi.org/10.1186/s12978-017-0396-0

[3] Asghari, E., Faramarzi, M., & Mohammmadi, A. (2016). The effect of cognitive behavioural therapy on anxiety, depression and stress in women with preeclampsia. Journal of Clinical and Diagnostic Research, 10(11), QC04-QC07. https://doi.org/10.7860/JCDR/2016/21245.8879

[4] Asghari, E., Faramarzi, M., & Mohammmadi, A. (2016). The effect of cognitive behavioural therapy on anxiety, depression and stress in women with preeclampsia. Journal of Clinical and Diagnostic Research, 10(11), QC04-QC07. https://doi.org/10.7860/JCDR/2016/21245.8879

[5] Austin, M. P. V., Middleton, P., Reilly, N. M., & Highet, N. J. (2013). Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines. Women Birth, 26(1), 2-9. https://doi.org/10.1016/j.wombi.2011.12.001

[6] Austin, M. P. V., Middleton, P., Reilly, N. M., & Highet, N. J. (2013). Detection and management of mood disorders in the maternity setting: The Australian Clinical Practice Guidelines. Women Birth, 26(1), 2-9. https://doi.org/10.1016/j.wombi.2011.12.001

[7] Bastani, F., Hidarnia, A., Kazemnejad, A., Vafaei, M., & Kashanian, M. (2005). A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. Journal of Midwifery & Women's Health, 50(4), e36-e40. https://doi.org/10.1016/j.jmwh.2004.11.008

[8] Bastani, F., Hidarnia, A., Kazemnejad, A., Vafaei, M., & Kashanian, M. (2005). A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. Journal of Midwifery & Women's Health, 50(4), e36-e40. https://doi.org/10.1016/j.jmwh.2004.11.008

[9] Battle, C., Salisbury, A., Schofield, C., & Ortiz-Hernandez, S. (2013). Perinatal Antidepressant Use: Understanding Women’s Preferences and Concerns. Journal of Psychiatric Practice, 19(6), 443-453. https://doi.org/10.1097/01.pra.0000438183.74359.46

[10] Battle, C., Salisbury, A., Schofield, C., & Ortiz-Hernandez, S. (2013). Perinatal Antidepressant Use: Understanding Women’s Preferences and Concerns. Journal of Psychiatric Practice, 19(6), 443-453. https://doi.org/10.1097/01.pra.0000438183.74359.46

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Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials

Affiliations

Mind-body interventions on stress management in pregnant women: A systematic review and meta-analysis of randomized controlled trials

Authors

Affiliations

Abstract
in English, Chinese

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Cited by

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Abstract in English, Chinese

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Cited by

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Abstract
in English, Chinese