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.
© 2020 John Wiley & Sons Ltd.