Meditation and Mindfulness for Recurrent Pregnancy Loss

In the Danish Recurrent Pregnancy Loss Unit in Rigshospitalet in Copenhagen recurrent pregnancy loss (RPL) is defined as three og more consecutive pregnancy losses in accordance with current European guidelines.

RPL affects approximately 3% of couples trying to achieve parenthood. Most cases of RPL are unexplained and have no effective treatment to improve the chance of a live birth.

42% of the women referred to RPL Unit in Rigshospitalet has a high stress level where as it's 22% in the background population trying to achieve parenthood. It's also known that 8,8 % of RPL patients have a depression at referral where as it's 2,2 % in the background population trying to achieve parenthood.

The study is a RCT including 62 patients - 31 in each arm. One arm will be taught in meditation and mindfulness three courses over a 7 week period. This group will also do meditation every day for 7 weeks. The other arm will have no intervention.

This study will investigate if a 7 weeks course in meditation and mindfulness is a useful tool to reduce stress and the psychological consequences for women and their partner treated in RPL Unit in Rigshospitalet, Copenhagen. Furthermore this study will investigate if there's a marital benefit such as reinforcement in their relationsship from practicing meditation and mindfulness.

There is no previous study that has investigated meditation and mindfulness for RPL.

This study has the potential to establish mental health support as a supplement to the medical and clinical treatment for RPL patients.

Study Overview

• Status: Unknown
• Conditions: Recurrent Pregnancy Loss
• Intervention / Treatment: Behavioral: Meditation and mindfulness

Detailed Description

The loss of a desired pregnancy is a significant negative life event associated with grief comparable to the grief after a peri- or neonatal death. Recurrent pregnancy loss (RPL) defined as 3 or more pregnancy losses affects approximately 3% of couples trying to have children. Most cases of RPL are unexplained and have no effective treatment to improve the chance of a live birth.

42% of the women referred to RPL Unit in Rigshospitalet has a high stress level where as it's 22% in the background population trying to achieve parenthood. It's also known that 8,8% of RPL patients have a depression at referral where as it's 2,2 % in the background population trying to achieve parenthood.

This study will investigate if a 7 weeks course in meditation and mindfulness is a useful tool to reduce stress and the psychological consequences for women and their partner treated in RPL Unit in Rigshospitalet, Copenhagen.

Furthermore this study will investigate if there's a marital benefit from practicing meditation and mindfulness. The investigators will use four different scales to measure the participants stress, depression, marital benefit and fertility stress. Also the investigators will measure the participants before and after the intervention and 12 months after.

All participants will have to complete:

1. Major Depression Index, a validated self-rating depression scale, which is used both clinically and in epidemiological studie. The 6-point Likert scale ranges from 0 (no depression) to 50 (extreme depression).
2. Perceived Stress Scale, which is a validated 10-item-self-reporting scale for stress symptoms. The 5 point Likert scale ranges from 0 (no stress) to 40 (extreme stress).
3. The COMPI Fertility Problem Stress Scale, a validated scale measuring the impact of RPL on the woman and her interpersonal relationships.
4. The COMPI Marital Benefit Scale measuring if RPL has reinforced the couples mariage/relationship.

The investigators assume that meditation and mindfulness can improve the quality of life for the RPL patients and their coping strategies. It's the investigators purpose to contribute with new knowledge in this area for current and future patients.

The RPL Unit in Rigshospitalet doesn't have any psychological support apart from ordinary attention from the nurses. This study has the potential to establish mental health support as a supplement to the medical and clinical treatment for RPL patients, which is in high demand.

• Study Type: Interventional
• Enrollment (Anticipated): 64
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Østerbro
    • Copenhagen, Østerbro, Denmark, 2100
      • Recruiting
      • Rigshospitalet
      • Contact: Henriette Svarre Nielsen, MD. MDSc; Phone Number: +4535458486; Email: Henriette.Svarre.Nielsen@regionh.dk
      • Contact: Karen Kirchheiner Jensen, Nurse; Phone Number: +4535458486; Email: Karen.Henriette.Jensen@regionh.dk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 46 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Women with RPL
• Speaking, reading and understanding Danish
• Have given a written consent
• Have a male partner
• Have a stress score > 16 points on Perceived Stress Scale

Exclusion Criteria:

• If the patient is pregnant on inclusion day
• If the patient already is practing meditation and mindfulness
• If the patient has a depression
• If the patient develops a depression after inclusion in either arm

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: Meditation and mindfulness intervention; Women in the intervention arm will 3 times receive a three hours work shop with introduction to meditation and mindfulness over a 7 week period from a certified meditation instructor. Questionnaires before and after the intervention.	Behavioral: Meditation and mindfulness; Women in the intervention arm will 3 times receive a three hours work shop with introduction to meditation and mindfulness over a 7 week period from a certified meditation instructor. Questionnaires before and after the intervention.
NO_INTERVENTION: Control group; Women in the no intervention arm will receive no introduction to meditation and mindfulness - only questionnaires at the same time as the intervention group receives questionnaires.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Stress Scale (PSS)	Change from baseline to 7 weeks after date of first course day measured by Perceived Stress Scale. PSS is a validated 10-item-self-reporting scale for stress symptoms. The 5 point Likert scale ranges from 0 (no stress) to 40 (extreme stress). The higher score the more stress.	7 weeks
Perceived Stress Scale (PSS)	Change from baseline to 12 months after date of first course day measured by the Perceived Stress Scale. PSS is a validated 10-item-self-reporting scale for stress symptoms. The 5 point Likert scale ranges from 0 (no stress) to 40 (extreme stress). The higher score the more stress.	12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
COMPI Fertility Problem Stress Scale	Change from baseline to 7 weeks after date of first course day using the COMPI Fertility Problem Stress Scale. The COMPI Fertility Problem Stress Scale is a validated scale measuring the impact of RPL on the woman and her interpersonal relationships. Two questions asking if the experience of RPL has been stressful for the woman with five answering options. Followed by seven sub questions asking how big a load RPL has been for the patients interpersonal life with four answering options. The lower the score the higher stress.	7 weeks
Marital Benefit Scale	Change in marital benefit from baseline to 7 weeks after date of first course day using the COMPI Marital Benefit Scale. The COMPI Marital Benefit Scale has two questions asking what the RPL have mattered for their relationship/mariage: Five options to answer: totally disagree, partly disagree, neither agree or disagree, partly agree, totally agree. Answering "Totally agree" on both questions is defined as a high marital benefit.	7 weeks
COMPI Fertility Problem Stress Scale	Change in fertility problem stress from baseline to 12 months after date of first course day using the COMPI Fertility Problem Stress Scale. The COMPI Fertility Problem Stress Scale is a validated scale measuring the impact of RPL on the woman and her interpersonal relationships. Two questions used to assess how big a impact RPL has for the patient with five answering options. Followed by seven sub questions asking how big a load RPL has been for the patients interpersonal life with four answering options. The lower the score the higher stress.	12 months
Marital Benefit	Change in marital benefit from baseline to 12 months after date of first course day using the COMPI Marital Benefit Scale. The COMPI Marital Benefit Scale has two questions asking what the RPL have mattered for their relationship/mariage: Five options to answer: totally disagree, partly disagree, neither agree or disagree, partly agree, totally agree. Answering "Totally agree" on both questions is defined as a high marital benefit.	12 months
Major Depression Index (MDI)	Change in depression score from baseline to 12 months after date of first course day. Major Depression Index is a validated self-rating depression scale, which is used both clinically and in epidemiological studie. The 6-point Likert scale ranges from 0 (no depression) to 50 (extreme depression).	12 months

Collaborators and Investigators

• Sponsor: Henriette Svarre Nielsen, MD, DMSc
• Investigators: Study Director: Karen Kirchheiner Jensen, Nurse, Rigshospitalet, Denmark

Study record dates

Study Major Dates

• Study Start (ACTUAL): February 2, 2019
• Primary Completion (ANTICIPATED): June 30, 2020
• Study Completion (ANTICIPATED): June 30, 2020

Study Registration Dates

• First Submitted: April 2, 2019
• First Submitted That Met QC Criteria: April 4, 2019
• First Posted (ACTUAL): April 5, 2019

Study Record Updates

• Last Update Posted (ACTUAL): April 5, 2019
• Last Update Submitted That Met QC Criteria: April 4, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Keywords: mindfulness; stress; Meditation; pregnancy loss
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Pregnancy Complications; Death; Recurrence; Abortion, Spontaneous; Abortion, Habitual; Fetal Death
• Other Study ID Numbers: H-18038456

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No