Stress-reducing interventions in pregnancy for the prevention of preterm birth: a systematic review and meta-analysis.
Journal of psychosomatic obstetrics and gynaecology – December 01, 2023
Source: PubMed
Summary
Stress-reducing interventions significantly lower the incidence of preterm birth (PTB) by 50% among low-risk pregnant women. An analysis of ten studies with 4,816 participants revealed that practices like Pilates, yoga, and mindfulness combined with education effectively reduced PTB rates. Additionally, these interventions positively impacted maternal anxiety and stress levels. Despite the promising findings, the overall quality of the studies was low and risk of bias was high, highlighting the need for higher-quality randomized controlled trials to further explore these benefits.
Abstract
Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Maternal stress during pregnancy is an established risk factor for PTB. We aimed to review the effects of stress-reducing interventions during pregnancy on PTB. Studies reporting on stress-reducing interventions during pregnancy and PTB rates in general low-risk obstetric populations were included. PTB rates, low birth weight (LBW) rates, mean gestational age and birth weight, maternal anxiety and stress, and adverse perinatal outcomes were investigated. Data were extracted using a standardized extraction form, pooled effect sizes were calculated with the random effects model. Ten studies with a total of 4.816 women were included. The interventions included Pilates, yoga, a multidisciplinary stress reduction program, combination therapy (combining mindfulness, yoga, music, baby bonding, and education), and hypnosis. The incidence of PTB was significantly lower in the intervention group (RR 0.50, 95% CI 0.35 - 0.71). The overall quality of the included studies was low, and the risk of bias was high. In conclusion, this study provides evidence supporting the potential efficacy of stress-reducing interventions in reducing the incidence of PTB in low-risk women. We propose a RCT of high quality to determine the effectiveness of stress-reducing interventions in reducing PTB risk.