Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis

Anjulie Dhillon, Elizabeth Sparkes, Rui V Duarte, Anjulie Dhillon, Elizabeth Sparkes, Rui V Duarte

Abstract

This systematic review aims to assess the effect of mindfulness-based interventions carried out during pregnancy exploring mindfulness and mental health outcomes. A systematic review was conducted to appraise the current literature on the subject area. Inclusion and exclusion criteria were agreed and after reviewing titles, abstracts and full papers, 14 articles met the inclusion criteria and were included in the review. The quality of included articles was checked using the Quality Assessment Tool for Quantitative Studies. Pooled results of the randomised controlled trials (RCTs) reporting outcomes on anxiety, depression and perceived stress indicated no differences between the mindfulness intervention group and the control group. Pooled results of the non-RCTs reporting anxiety, depression and perceived stress showed a significant benefit for the mindfulness group. Mindfulness as an outcome was assessed in four RCTs for which the pooled results show a significant difference in favour of the mindfulness intervention when compared to a control group. The pooled results of the four non-RCTs also indicate a significant difference following mindfulness intervention. Results suggest that mindfulness-based interventions can be beneficial for outcomes such as anxiety, depression, perceived stress and levels of mindfulness during the perinatal period. Further research would be useful to explore if such benefits are sustained during the post-natal period.

Keywords: Childbirth; Labour; Maternal health; Mindfulness; Perinatal; Pregnancy.

Conflict of interest statement

Funding

None of the authors had any direct or indirect funding in support of this study.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Conflict of Interest

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flowchart detailing the study selection process
Fig. 2
Fig. 2
Pooled results for change in anxiety from RCTs and non-RCTs
Fig. 3
Fig. 3
Pooled results for change in depression from RCTs and non-RCTs
Fig. 4
Fig. 4
Pooled results for change in perceived stress from RCTs and non-RCTs
Fig. 5
Fig. 5
Pooled results for change in mindfulness awareness from RCTs and non-RCTs

References

    1. Arendt K, Tessmer-Tuck J. Nonpharmacologic labor analgesia. Clinics in Perinatology. 2013;40(3):351–371. doi: 10.1016/j.clp.2013.05.007.
    1. Beattie J, Hall H, Biro M, East C. Does mindfulness training reduce the stress of pregnancy? Australian Nursing & Midwifery Journal. 2014;22(1):39.
    1. Beddoe A, Lee K. Mind-body interventions during pregnancy. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2008;37(2):165–175. doi: 10.1111/j.1552-6909.2008.00218.x.
    1. Beddoe AE, Paul Yang CP, Kennedy HP, Weiss SJ, Lee KA. The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2009;38(3):310–319. doi: 10.1111/j.1552-6909.2009.01023.x.
    1. Bonari L, Pinto N, Ahn E, Einarson A, Steiner M, Koren G. Perinatal risks of untreated depression during pregnancy. Canadian Journal of Psychiatry. 2004;49(11):726–735. doi: 10.1177/070674370404901103.
    1. Bowen A, Baetz M, Schwartz L, Balbuena L, Muhajarine N. Antenatal group therapy improves worry and depression symptoms. The Israel Journal of Psychiatry and Related Sciences. 2014;51(3):226–231.
    1. Byrne J, Hauck Y, Fisher C, Bayes S, Schutze R. Effectiveness of a mindfulness-based childbirth education pilot study on maternal self-efficacy and fear of childbirth. Journal of Midwifery & Women’s Health. 2014;59(2):192–197. doi: 10.1111/jmwh.12075.
    1. Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. The Journal of Alternative and Complementary Medicine. 2009;15(5):593–600. doi: 10.1089/acm.2008.0495.
    1. Cohen JS. Mindfulness and self-compassion in the transition to motherhood: a prospective study of postnatal mood and attachment. New York: Columbia University; 2010.
    1. Curtis K, Weinrib A, Katz J. Systematic review of yoga for pregnant women: current status and future directions. Evidence-based Complementary and Alternative Medicine. 2012;2012:1–13. doi: 10.1155/2012/715942.
    1. Deeks JJ, Dinnes J, D'Amico R, Sowden AJ, Sakarovitch C, Song F, Petticrew M, Altman DG, International Stroke Trial Collaborative Group; European Carotid Surgery Trial Collaborative Group Evaluating non-randomised intervention studies. Health Technology Assessment. 2003;7(27):1–173. doi: 10.3310/hta7270.
    1. Dimidjian S, Goodman SH, Felder JN, Gallop R, Brown AP, Beck A. An open trial of mindfulness-based cognitive therapy for the prevention of perinatal depressive relapse/recurrence. Archives of Women's Mental Health. 2015;18(1):85–94. doi: 10.1007/s00737-014-0468-x.
    1. Dimidjian S, Goodman SH, Felder JN, Gallop R, Brown AP, Beck A. Staying well during pregnancy and the postpartum: a pilot randomized trial of mindfulness-based cognitive therapy for the prevention of depressive relapse/recurrence. Journal of Consulting and Clinical Psychology. 2016;84(2):134–145. doi: 10.1037/ccp0000068.
    1. Dole N. Maternal stress and preterm birth. American Journal of Epidemiology. 2003;157(1):14–24. doi: 10.1093/aje/kwf176.
    1. Donegan T. Mindfulness: an intervention for improving the health of mothers and babies. Midwifery Today. 2015;113:62–63.
    1. Duncan LG, Bardacke N. Mindfulness-based childbirth and parenting education: promoting family mindfulness during the perinatal period. Journal of Child and Family Studies. 2010;19(2):190–202. doi: 10.1007/s10826-009-9313-7.
    1. Dunn C, Hanieh E, Roberts R, Powrie R. Mindful pregnancy and childbirth: effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period. Archives of Women's Mental Health. 2012;15(2):139–143. doi: 10.1007/s00737-012-0264-4.
    1. Effective Public Health Practice Project. (1998). Quality assessment tool for quantitative studies. . Accessed 7 March 2016.
    1. Escott D, Spiby H, Slade P, Fraser R. The range of coping strategies women use to manage pain and anxiety prior to and during first experience of labour. Midwifery. 2004;20(2):144–156. doi: 10.1016/j.midw.2003.11.001.
    1. Evans J, Heron J, Francomb H, Oke S, Golding J. Cohort study of depressed mood during pregnancy and after childbirth. BMJ. 2001;323(7307):257–260. doi: 10.1136/bmj.323.7307.257.
    1. Field T. Pregnancy and labor alternative therapy research. Alternative Therapies in Health and Medicine. 2008;14(5):28–34.
    1. Fisher C, Hauck Y, Bayes S, Byrne J. Participant experiences of mindfulness-based childbirth education: a qualitative study. BMC Pregnancy and Childbirth. 2012;12(1):126. doi: 10.1186/1471-2393-12-126.
    1. Glover V. Annual research review: prenatal stress and the origins of psychopathology: an evolutionary perspective. Journal of Child Psychology and Psychiatry. 2011;52(4):356–367. doi: 10.1111/j.1469-7610.2011.02371.x.
    1. Glynn L, Schetter C, Hobel C, Sandman C. Pattern of perceived stress and anxiety in pregnancy predicts preterm birth. Health Psychology. 2008;27(1):43–51. doi: 10.1037/0278-6133.27.1.43.
    1. Goodman JH, Guarino A, Chenausky K, Klein L, Prager J, Petersen R, Forget A, Freeman M. CALM pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Archives of Women's Mental Health. 2014;17(5):373–387. doi: 10.1007/s00737-013-0402-7.
    1. Guardino CM, Dunkel Schetter C, Bower JE, Lu MC, Smalley SL. Randomised controlled pilot trial of mindfulness training for stress reduction during pregnancy. Psychology & Health. 2014;29(3):334–349. doi: 10.1080/08870446.2013.852670.
    1. Hall H, Beattie J, Lau R, East C, Biro M. The effectiveness of mindfulness training on perinatal mental health; a systematic review. Women and Birth. 2015;29(1):62–71. doi: 10.1016/j.wombi.2015.08.006.
    1. Hofmann S, Sawyer A, Witt A, Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology. 2010;78(2):169–183. doi: 10.1037/a0018555.
    1. Huizink AC, Mulder EJ, Robles de Medina PG, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome? Early Human Development. 2004;79(2):81–91. doi: 10.1016/j.earlhumdev.2004.04.014.
    1. Iyengar, B. K. S. (1979). Light on yoga. New York: Schocken Books.
    1. Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Dellacourt; 1990.
    1. Kabat-Zinn J. Wherever you go, there you are. London: Piatkus; 1994.
    1. Khianman B, Pattanittum P, Thinkhamrop J, Lumbiganon P. Relaxation therapy for preventing and treating preterm labour. Cochrane Database of Systematic Reviews. 2012;8:CD007426.
    1. Kim HH, Nava-Ocampo AA, Kim SK, Kim SH, Kim YJ, Han JY, Ahn HK, Ryu HM, Yang JH, Kim MY. Is prenatal childbirth preparation effective in decreasing adverse maternal and neonatal response to labor? A nested case-control study. Acta Biomedica de l'Ateneo Parmense. 2008;79(1):18–22.
    1. Kinser P, Robins J. Control group design: enhancing rigor in research of mind-body therapies for depression. Evidence-based Complementary and Alternative Medicine. 2013;2013:1–10. doi: 10.1155/2013/140467.
    1. Koyyalamudi V, Sidhu G, Cornett E, Nguyen V, Labrie-Brown C, Fox C, Kaye A. New labor pain treatment options. Current Pain and Headache Reports. 2016;20(2):11. doi: 10.1007/s11916-016-0543-2.
    1. Liberto TL. Screening for depression and help-seeking in postpartum women during well-baby pediatric visits: an integrated review. Journal of Pediatric Health Care. 2012;26(2):109–117. doi: 10.1016/j.pedhc.2010.06.012.
    1. Maina G, Saracco P, Giolito MR, Danelon D, Bogetto F, Todros T. Impact of maternal psychological distress on fetal weight, prematurity and intrauterine growth retardation. Journal of Affective Disorders. 2008;111(2–3):214–220. doi: 10.1016/j.jad.2008.02.017.
    1. Marc L, Toureche N, Hodnett E, Blanchet C, Dodin S, Njoya M. Mind-body interventions during pregnancy for preventing or treating women’s anxiety. Cochrane Database of Systematic Reviews. 2011;7:CD007559.
    1. Matvienko-Sikar K, Dockray S. Effects of a novel positive psychological intervention on prenatal stress and well-being: a pilot randomised controlled trial. Women and Birth. 2016
    1. McBride D. The process of research in psychology. Los Angeles: SAGE; 2015.
    1. Miklowitz D, Semple R, Hauser M, Elkun D, Weintraub M, Dimidjian S. Mindfulness-based cognitive therapy for perinatal women with depression or bipolar spectrum disorder. Cognitive Therapy and Research. 2015;39(5):590–600. doi: 10.1007/s10608-015-9681-9.
    1. Muthukrishnan S, Jain R, Kohli S, Batra S. Effect of mindfulness meditation on perceived stress scores and autonomic function tests of pregnant Indian women. Journal of Clinical and Diagnostic Research. 2016;10(4):5–8.
    1. Piet J, Würtzen H, Zachariae R. The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology. 2012;80(6):1007–1020. doi: 10.1037/a0028329.
    1. Rich-Edwards JW, Kleinman K, Abrams A, Harlow BL, McLaughlin TJ, Joffe H, Gillman MW. Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. Journal of Epidemiology and Community Health. 2006;60(3):221–227. doi: 10.1136/jech.2005.039370.
    1. Robertson E, Celasun N, Stewart DE. Risk factors for postpartum depression. In: Stewart DE, Robertson E, Dennis CL, Grace SL, Wallington T, editors. Postpartum depression: literature review of risk factors and interventions. Toronto: Toronto Public Health; 2003. pp. 9–70.
    1. Roth B, Robbins D. Mindfulness-based stress reduction and health-related quality of life: findings from a bilingual inner-city patient population. Psychosomatic Medicine. 2004;66(1):113–123. doi: 10.1097/01.PSY.0000097337.00754.09.
    1. Schetter CD, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Current Opinion in Psychiatry. 2012;25(2):141–148. doi: 10.1097/YCO.0b013e3283503680.
    1. Shahtaheri E, Hosseinian S, Ebrahimi M, Jalilabadi Z, Mirderikvand F. The impact of stress reduction program based on mindfulness and conscious yoga on depression, perceived stress and quality of life in pregnant women. Acta Medica Mediterranea. 2016;32(5):2047–2050.
    1. Smith CA, Levett KM, Collins CT, Crowther C. Relaxation techniques for pain management in labour. Cochrane Database of Systematic Reviews. 2011;12:CD009514.
    1. Sparkes, E. (2015). The birth plan? Really? The Huffington Post. . Accessed 9 May 2016.
    1. Talge NM, Neal C, Glover V. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? Journal of Child Psychology and Psychiatry. 2007;48(3–4):245–261. doi: 10.1111/j.1469-7610.2006.01714.x.
    1. Vieten C, Astin J. Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Archives of Women's Mental Health. 2008;11(1):67–74. doi: 10.1007/s00737-008-0214-3.
    1. Wadhwa PD, Entringer S, Buss C, Lu MC. The contribution of maternal stress to preterm birth: issues and considerations. Clinics in Perinatology. 2011;38(3):351–384. doi: 10.1016/j.clp.2011.06.007.
    1. Woolhouse H, Mercuri K, Judd F, Brown SJ. Antenatal mindfulness intervention to reduce depression, anxiety and stress: a pilot randomised controlled trial of the MindBabyBody program in an Australian tertiary maternity hospital. BMC Pregnancy and Childbirth. 2014;14:369. doi: 10.1186/s12884-014-0369-z.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere